Management of massive presacral pelvic bleeding in patients with gynecological malignances: review of the literature.

Hemorrhage has always been a significant potential complication in the field of gynecological oncology. Throughout the years, a variety of medical and surgical modalities aimed at controlling pelvic hemorrhage have been developed. Most recently, these have focused on attempting to decrease the morbidity associated with pelvic bleeding. The effectiveness of and the complications involved in controlling massive hemorrhage by the preemptive method of vascular clamping of the aorta, intraoperative methods, such as the local application of procoagulants and of prolonged compression (pelvic gauze packing, plastic wrapped gauze packing, autograft tissue compression and balloon compression) have all been reviewed. Surgeons are able to acquaint themselves with the choice of methods that can be employed during massive pelvic bleeding resulting from procedures on gynecological malignancies.