The Experts below are selected from a list of 51 Experts worldwide ranked by ideXlab platform

Shi Jing-sen - One of the best experts on this subject based on the ideXlab platform.

  • Severe presacral hemorrhage during proctectomy of rectal cancer
    Journal of Modern Oncology, 2005
    Co-Authors: Shi Jing-sen
    Abstract:

    Severe presacral hemorrhage is a serious complication during proctectomy. Its average incidence reported ranges from 2.17% to 3.21%, and fatality from 4.96% to 13.64%. Determined by the anatomic features of the presacral region, the hydrostatic pressure of the distal presacral Veins can reach as high as 17 to 23 cm H_2O, approximately double or triple that of the normal inferior vena cava. Bleeding of ruptured presacral venous plexus and that of sacral Basivertebral Veins have different clinical characteristics. Although in this article, numerous hemostatic methods were reviewed for various bleeding types, we hold that prevention is more important, the key of which is to master the anatomy of presacral region and the techniques in mobilizing rectum.

Thomas-marc Markwalder - One of the best experts on this subject based on the ideXlab platform.

  • Cement leakage and the need for prophylactic fenestration of the spinal canal during vertebroplasty.
    The Journal of bone and joint surgery. American volume, 2002
    Co-Authors: Markus Wenger, Thomas-marc Markwalder
    Abstract:

    To The Editor: We read with great interest Dr. Harrington's important article, "Major Neurological Complications Following Percutaneous Vertebroplasty with Polymethylmethacrylate. A Case Report" (2001;83:1070-3). We were recently confronted with a very similar problem in our series of patients (currently fifty-two patients [ninety-five vertebrae]) treated with vertebroplasty1. An eighty-year-old woman with an osteoporotic fracture of the twelfth thoracic vertebra underwent percutaneous transpedicular vertebroplasty (methylmethacrylate, tantalum, erythromycin; fluoroscopy) with significant cement leakage through Basivertebral Veins into the spinal canal. Despite immediate surgical removal of the spilled cement, the preexisting paraparesis was appreciably aggravated because of cord compression1. Since this occurrence, we prophylactically fenestrate the spinal canal in all patients1. Unlike …

Rong-gui Meng - One of the best experts on this subject based on the ideXlab platform.

  • Massive presacral bleeding during rectal surgery: from anatomy to clinical practice.
    World journal of gastroenterology, 2013
    Co-Authors: Zheng Lou, Wei Zhang, Rong-gui Meng
    Abstract:

    AIM: To investigate control of two different types of massive presacral bleeding according to the anatomy of the presacral venous system. METHODS: A retrospective review was performed in 1628 patients with middle or low rectal carcinoma who were treated surgically in the Department of Colorectal Surgery, Changhai Hospital, Shanghai, China from January 2008 to December 2012. In four of these patients, the presacral venous plexus (n = 2) or Basivertebral Veins (n = 2) were injured with massive presacral bleeding during mobilization of the rectum. The first two patients with low rectal carcinoma were operated upon by a junior associate professor and the source of bleeding was the presacral venous plexus. The other two patients with recurrent rectal carcinoma were both women and the source of bleeding was the Basivertebral Veins. RESULTS: Two different techniques were used to control the bleeding. In the first two patients with massive bleeding from the presacral venous plexus, we used suture ligation around the venous plexus in the area with intact presacral fascia that communicated with the site of bleeding (surrounding suture ligation). In the second two patients with massive bleeding from the Basivertebral Veins, the pelvis was packed with gauze, which resulted in recurrent bleeding as soon as it was removed. Following this, we used electrocautery applied through one epiploic appendix pressed with a long Kelly clamp over the bleeding sacral neural foramen where was felt like a pit Electrocautery adjusted to the highest setting was then applied to the clamp to “weld” closed the bleeding point. Postoperatively, the blood loss was minimal and the drain tube was removed on days 4-7. CONCLUSION: Surrounding suture ligation and epiploic appendices welding are effective techniques for controlling massive presacral bleeding from presacral venous plexus and sacral neural foramen, respectively.

Andrew G. Hill - One of the best experts on this subject based on the ideXlab platform.

  • Management of Presacral/Pelvic Bleeding
    Gastrointestinal Surgery, 2015
    Co-Authors: Sanket Srinivasa, Andrew G. Hill
    Abstract:

    Presacral bleeding is a rare but clinically significant event during pelvic dissection. It is characterised by high-volume, rapid bleeding from the presacral venous plexus or the Basivertebral Veins. It can be prevented by posterior rectal dissection being performed sharply in the plane anterior to the presacral fascia. Bleeding should be dealt with by packing the pelvis and identifying the bleeding point. Management is dependent upon whether the bleeding has arisen from presacral or Basivertebral Veins. Successful strategies in open- and minimal-access surgery include suture ligation, use of sterile thumbtacks, argon plasma coagulation, haemostatic agents and tamponade with muscle or epiploic appendices.

Markus Wenger - One of the best experts on this subject based on the ideXlab platform.

  • Cement leakage and the need for prophylactic fenestration of the spinal canal during vertebroplasty.
    The Journal of bone and joint surgery. American volume, 2002
    Co-Authors: Markus Wenger, Thomas-marc Markwalder
    Abstract:

    To The Editor: We read with great interest Dr. Harrington's important article, "Major Neurological Complications Following Percutaneous Vertebroplasty with Polymethylmethacrylate. A Case Report" (2001;83:1070-3). We were recently confronted with a very similar problem in our series of patients (currently fifty-two patients [ninety-five vertebrae]) treated with vertebroplasty1. An eighty-year-old woman with an osteoporotic fracture of the twelfth thoracic vertebra underwent percutaneous transpedicular vertebroplasty (methylmethacrylate, tantalum, erythromycin; fluoroscopy) with significant cement leakage through Basivertebral Veins into the spinal canal. Despite immediate surgical removal of the spilled cement, the preexisting paraparesis was appreciably aggravated because of cord compression1. Since this occurrence, we prophylactically fenestrate the spinal canal in all patients1. Unlike …