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Endoscopic management of postoperative anastomotic bleeding in patients with colorectal cancer

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  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Postoperative anastomotic bleeding is considered a rare but life-threatening complication. There is no standard treatment strategy for this emergency condition. The aim of this study was to report our experiences in the management of postoperative anastomotic bleeding in patients with colorectal cancer.

Methods

We analyzed the general characteristics, treatments, and outcomes of patients with anastomotic bleeding after surgery for colorectal carcinoma at the Sixth Affiliated Hospital of Sun Yat-Sen University between July 2013 and September 2019 retrospectively. A univariate and multivariate analysis was performed to find protective factors for endoscopic hemostasis. Risk factors for anastomotic leakage after colonoscopy were also analyzed.

Results

A total of 9870 patients underwent surgeries for colorectal carcinoma between July 2013 and September 2019. Colonoscopies were performed in 78 cases with postoperative anastomotic bleeding. The effective rate of initial endoscopic hemostasis was 81% (63/78). In univariate and multivariate analysis, hemoclip therapy (odds ratio = 4.572; 95%CI 1.305–16.017; P = 0.017) and postoperative anastomotic bleeding within 5 days (odds ratio = 3.639; 95%CI 1.045–12.675; P = 0.042) are protective factors for endoscopic hemostasis. Comorbidity was associated with an increased risk for anastomotic leakage.

Conclusions

Colonoscopy seems to be an effective way to achieve hemostasis for patients with anastomotic bleeding after surgery for colorectal carcinoma. It may be more effective in the early postoperative period, and hemoclip appears to be the first choice to control postoperative anastomotic bleeding.

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Funding

This study was financially supported by National Key Clinical Discipline and Medical Science and Technology Foundation of Guangdong Province of China (A2019487).

Author information

Author notes

  1. Wei Liu and Dezheng Lin contributed equally to this study and should be considered as co-first authors.

Authors and Affiliations

  1. Department of Endoscopic Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, 26 Yuancun Erheng Road, Guangzhou, Guangdong, China

    Wei Liu, Dezheng Lin, Qinghua Zhong, Mingli Su, Juan Li, Xuefeng Guo & Jiancong Hu

  2. Department of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China

    Juan Li, Xuefeng Guo & Jiancong Hu

  3. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China

    Xuefeng Guo & Jiancong Hu

Authors
  1. Wei Liu
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  2. Dezheng Lin
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  3. Qinghua Zhong
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  4. Mingli Su
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  5. Juan Li
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  6. Xuefeng Guo
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  7. Jiancong Hu
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Contributions

WL and DZL contributed to study concept and design, acquisition, analysis, interpretation of data, and drafting of the manuscript. QHZ, JL, and MLS contributed to data collections and manuscript review. JCH and XFG supervised the study. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xuefeng Guo or Jiancong Hu.

Ethics declarations

Institutional review board statement

This study was approved by the Institutional Review Board (IRB) of The Sixth Affiliated Hospital of Sun Yat-sen University.

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The authors declare that they have no conflict of interest.

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Liu, W., Lin, D., Zhong, Q. et al. Endoscopic management of postoperative anastomotic bleeding in patients with colorectal cancer. Int J Colorectal Dis 35, 1703–1709 (2020). https://doi.org/10.1007/s00384-020-03614-x

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  • DOI: https://doi.org/10.1007/s00384-020-03614-x

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