To explore the risk factors and management strategy of postoperative anastomotic hemorrhage after double-stapling anastomosis in anterior resection for rectal cancer.

A total of 455 patients undergoing double-stapling anastomosis in anterior resection for rectal cancer between January 2010 and December 2014 were included in the study. The clinical data were retrospectively reviewed.

Of the 455 patients, 142 underwent laparoscopic surgery and 303 underwent open surgery. Anastomotic hemorrhage occurred in 10 patients received super-low anastomosis. Of these patients, 7 underwent open surgery and 3 underwent laparoscopic surgery. Three cases were treated with intravenous hemostatic agent, 4 with endoscopic titanium clip hemostasis, 1 with suture hemostasis through anoscope, 1 with interventional therapy and 1 with reoperation.

Anastomotic hemorrhage may mainly related to the level of colorectal anastomoses and should be mainly treated with conservative method. Interventional and endoscopic therapies are two effective methods for treating anastomotic hemorrhage.