<p><b>OBJECTIVE</b>To evaluate the effect of compression
hemostasis with an
arc -shaped transperineal incision in front of the apex of
coccyx in controlling presacral venous plexus
hemorrhage during rectectomy.</p><p><b>
METHODS </b>From October 2002 to October 2012, 52
patients with
rectal cancer received
neoadjuvant radiotherapy and developed presacral venous plexus
hemorrhage during rectectomy, included 36
male and 26
female cases. Their age were 36-65 years. The
hemostasis time and
blood loss were analyzed.</p><p><b>RESULTS</b>All 52
patients achieved R0 resection. Of which 13
patients achieved
suture hemostasis within 15 minutes, whereas 22
patients unsuccessfully treated within 15 minutes received compression
hemostasis with an
arc -shaped transperineal incision in front of the apex of
coccyx . The median
blood loss was (196 ± 44)ml and
hospitalization time was (15.2 ± 1.7)days in this group. Additionally, 7
patients achieved
suture hemostasis within 20 minutes except 4
patients who received compression
hemostasis , with a median
blood loss of (1016 ± 86)ml and
hospitalization time of (21.7 ± 6.3)days. Other 6
patients achieved
suture hemostasis within 30 minutes except 3
patients who received compression
hemostasis , with a median
blood loss of (2508 ± 73)ml and the
hospitalization time was (28.8 ± 3.3)days. There was statistically significant difference of
bleeding (F = 4289.562) and
hospitalization time (F = 50.121) in 3 groups of
patients (P = 0.000).</p><p><b>CONCLUSIONS</b>Once intraoperative presacral venous plexus
hemorrhage can't be stopped timely, compression
hemostasis with an
arc -shaped transperineal incision in front of the apex of
coccyx is an effective alternative for the
patients with
rectal cancer who received
neoadjuvant radiotherapy .</p>