Clinical Evaluation of Lower Abdominal Aorta Balloon Occlusion in Pelvic or Sacral Tumor Resection_West China Medical Journal

Authors：

 LUOYi , DUANHong , MINLi , SHIRui , ZHANGWei-li , ZHOUYong , ZOUChang ,  TUChong-qi

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

TUChong-qi, Email: tuchongqi@163.com

Keywords：

Sacrum tumor; Pelvic tumor; Balloon occlusion; Abdominal aorta; Complication

DOI：

10.7507/1002-0179.20140148

Video：

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Objective To investigate the clinical efficiency of pelvic and sacrum tumor surgery using sizing balloon occlusion of the lower abdominal aorta. Methods From January 2005 to June 2011, 156 patients were diagnosed to have sacrum or pelvic tumor and underwent surgery in our institution. Temporary balloon occlusion of abdominal aorta was used in 51 patients during the resection of sacrum and pelvic tumors (balloon group). Another 105 patients received the traditional surgery resection (control group). The results of the whole operation time, the volume of blood loss and transfusion, the complication and the total days of stay in hospital in the two groups were compared with each other. Results After the abdominal aorta was occluded, 92.2% of the patients in the balloon group had holistic resection or edge resection, while the number was 86.7% for the control group. In the balloon group, the average operation time was (171.96±65.16) minutes, the average intraoperative blood loss was (746.86±722.73) mL, and the blood transfusion was (411.76±613.73) mL. The postoperative lead flow was (294.50±146.09) mL, and the postoperative tube removal was within (2.98±1.07) days. Improvement of patients'condition was significantly better than the control group (P<0.05). No significant difference was found in the total days of stay in hospital and the postoperative complications between the two groups (P>0.05). Conclusion Using abdominal aorta occlusion can effectively control intraoperative hemorrhage, and show the operation field clearly. It also can reduce operation time and control the blood transfusions. Appropriately extended balloon blocking time can obviously improve the tumor removal rate and the safety of the operation.

Citation： LUOYi, DUANHong, MINLi, SHIRui, ZHANGWei-li, ZHOUYong, ZOUChang, TUChong-qi. Clinical Evaluation of Lower Abdominal Aorta Balloon Occlusion in Pelvic or Sacral Tumor Resection. West China Medical Journal, 2014, 29(3): 494-498. doi: 10.7507/1002-0179.20140148 Copy

1.	Simpson AH, Porter A, Davis A, et al. Cephalad sacral resection with a combined extended ilioinguinal and posterior approach[J]. J Bone Joint Surg Am, 1995, 77(3):405-411.
2.	Zhang ZY, Fu CF, Yang YX, et al. Long-term outcomes following en bloc resection for sacral tumor:a retrospective analysis of 93 cases[J]. Orthopedics, 2011, 34(8):e403-e407.
3.	郭卫, 徐万鹏, 杨荣利, 等. 骶骨肿瘤的手术治疗[J]. 中华外科杂志, 2003, 41(11):30-34.
4.	李世德, 尹文军. 骶骨肿瘤术中4种控制出血方法临床效果评价[J]. 实用肿瘤杂志, 2011, 26(5):526-529.
5.	陈文华, 王祁, 何忠明, 等. 术前肿瘤动脉栓塞联合术中腹主动脉球囊阻断在骶骨肿瘤切除术中的应用[J]. 介入放射学杂志, 2012, 21(3):212-215.
6.	Salai M, Garniek A, Rubinstein Z, et al. Preoperative angiography and embolization of large pelvic tumors[J]. J Surg Oncol, 1999, 70(1):41-44.
7.	Wirbel RJ, Roth R, Schulte M, et al. Preoperative embolization in spinal and pelvic metastases[J]. J Orthop Sci, 2005, 10(3):253-257.
8.	Chatziioannou AN, Johnson ME, Pneumaticos SG, et al. Preoperative embolization of bone metastases from renal cell carcinoma[J]. Eur Radiol, 2000, 10(4):593-596.
9.	张兰, 屠重棋, 杨经文, 等. 腹主动脉内球囊阻断术在骨盆和骶骨手术中的应用[J]. 中华麻醉学杂志, 2004, 24(2):151-152.
10.	Mi C, Lu H, Liu H. Surgical excision of sacral tumors assisted by occluding the abdominal aorta with a balloon dilation catheter:a report of 3 cases[J]. Spine (Phila Pa 1976), 2005, 30(20):E614-E616.
11.	Yang L, Chong-Qi T, Hai-Bo S, et al. Appling the abdominal aortic-balloon occluding combine with blood pressure sensor of dorsal artery of foot to control bleeding during the pelvic and sacrum tumors surgery[J]. J Surg Oncol, 2008, 97(7):626-628.
12.	Zhang L, Gong Q, Xiao H, et al. Control of blood loss during sacral surgery by aortic balloon occlusion[J]. Anesth Analg, 2007, 105(3):700-703.
13.	熊娅琴, 宋海波, 屠重棋, 等. 彩色多普勒超声引导下腹主动脉内球囊阻断术在骨盆和骶尾部肿瘤手术的应用研究[J]. 四川大学学报:医学版, 2012, 43(5):715-719.
14.	黄斌, 赵纪春, 马玉奎, 等. 低位腹主动脉内球囊阻断技术在骨盆和骶骨肿瘤切除术中的应用[J]. 中国普外基础与临床杂志, 2011, 18(6):635-638.
15.	韦玮, 李世德, 詹新立, 等. 暂时低位腹主动脉阻断患者T-SOD及MDA的变化和临床意义[J]. 广东医学, 2009(12):1833-1835.
16.	赵纪春, 马玉奎, 黄斌, 等. 腹主动脉瘤患者腔内治疗与开腹修复术的围手术期比较[J]. 中华医学杂志, 2012, 92(47):3324-3328.
17.	Bracale UM, Corte G, Del Guercio L, et al. Endovascular treatment of abdominal aortic anastomotic pseudoaneurysm. The experience of two centers[J]. Ann Ital Chir, 2012, 83(6):509-513.
18.	Akoz T, Yildirim S, Akan M, et al. Can indications for lower limb replantation and revascularization be expanded with simultaneous free-flap transfer for limb salvage?[J]. J Reconstr Microsurg, 2004, 20(8):621-629.
19.	Fang CL, Yang CS, Tang HC, et al. Successful replantation of amputated bilateral lower limbs[J]. Plast Reconstr Surg, 2012, 129(1):215e-217e.
20.	Hierner R, Betz AM, Comtet JJ, et al. Decision making and results in subtotal and total lower leg amputations:reconstruction versus amputation[J]. Microsurgery, 1995, 16(12):830-839.
21.	Atar E, Bachar GN, Bartal G, et al. Use of peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures[J]. J Vasc Interv Radiol, 2005, 16(2 Pt 1):241-245.
22.	Tang X, Guo W, Yang R, et al. Use of aortic balloon occlusion to decrease blood loss during sacral tumor resection[J]. J Bone Joint Surg Am, 2010, 92(8):1747-1753.
23.	Ji T, Guo W, Tang XD, et al. Reconstruction of type Ⅱ+Ⅲ pelvic resection with a modular hemipelvic endoprosthesis:a finite element analysis study[J]. Orthop Surg, 2010, 2(4):272-277.
24.	Tang X, Guo W, Ji T. Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis[J]. Arch Orthop Trauma Surg, 2011, 131(12):1609-1615.
25.	Zhou Y, Duan H, Liu Y, et al. Outcome after pelvic sarcoma resection and reconstruction with a modular hemipelvic prostheses[J]. Int Orthop, 2011, 35(12):1839-1846.

1. Simpson AH, Porter A, Davis A, et al. Cephalad sacral resection with a combined extended ilioinguinal and posterior approach[J]. J Bone Joint Surg Am, 1995, 77(3):405-411.
2. Zhang ZY, Fu CF, Yang YX, et al. Long-term outcomes following en bloc resection for sacral tumor:a retrospective analysis of 93 cases[J]. Orthopedics, 2011, 34(8):e403-e407.
3. 郭卫, 徐万鹏, 杨荣利, 等. 骶骨肿瘤的手术治疗[J]. 中华外科杂志, 2003, 41(11):30-34.
4. 李世德, 尹文军. 骶骨肿瘤术中4种控制出血方法临床效果评价[J]. 实用肿瘤杂志, 2011, 26(5):526-529.
5. 陈文华, 王祁, 何忠明, 等. 术前肿瘤动脉栓塞联合术中腹主动脉球囊阻断在骶骨肿瘤切除术中的应用[J]. 介入放射学杂志, 2012, 21(3):212-215.
6. Salai M, Garniek A, Rubinstein Z, et al. Preoperative angiography and embolization of large pelvic tumors[J]. J Surg Oncol, 1999, 70(1):41-44.
7. Wirbel RJ, Roth R, Schulte M, et al. Preoperative embolization in spinal and pelvic metastases[J]. J Orthop Sci, 2005, 10(3):253-257.
8. Chatziioannou AN, Johnson ME, Pneumaticos SG, et al. Preoperative embolization of bone metastases from renal cell carcinoma[J]. Eur Radiol, 2000, 10(4):593-596.
9. 张兰, 屠重棋, 杨经文, 等. 腹主动脉内球囊阻断术在骨盆和骶骨手术中的应用[J]. 中华麻醉学杂志, 2004, 24(2):151-152.
10. Mi C, Lu H, Liu H. Surgical excision of sacral tumors assisted by occluding the abdominal aorta with a balloon dilation catheter:a report of 3 cases[J]. Spine (Phila Pa 1976), 2005, 30(20):E614-E616.
11. Yang L, Chong-Qi T, Hai-Bo S, et al. Appling the abdominal aortic-balloon occluding combine with blood pressure sensor of dorsal artery of foot to control bleeding during the pelvic and sacrum tumors surgery[J]. J Surg Oncol, 2008, 97(7):626-628.
12. Zhang L, Gong Q, Xiao H, et al. Control of blood loss during sacral surgery by aortic balloon occlusion[J]. Anesth Analg, 2007, 105(3):700-703.
13. 熊娅琴, 宋海波, 屠重棋, 等. 彩色多普勒超声引导下腹主动脉内球囊阻断术在骨盆和骶尾部肿瘤手术的应用研究[J]. 四川大学学报:医学版, 2012, 43(5):715-719.
14. 黄斌, 赵纪春, 马玉奎, 等. 低位腹主动脉内球囊阻断技术在骨盆和骶骨肿瘤切除术中的应用[J]. 中国普外基础与临床杂志, 2011, 18(6):635-638.
15. 韦玮, 李世德, 詹新立, 等. 暂时低位腹主动脉阻断患者T-SOD及MDA的变化和临床意义[J]. 广东医学, 2009(12):1833-1835.
16. 赵纪春, 马玉奎, 黄斌, 等. 腹主动脉瘤患者腔内治疗与开腹修复术的围手术期比较[J]. 中华医学杂志, 2012, 92(47):3324-3328.
17. Bracale UM, Corte G, Del Guercio L, et al. Endovascular treatment of abdominal aortic anastomotic pseudoaneurysm. The experience of two centers[J]. Ann Ital Chir, 2012, 83(6):509-513.
18. Akoz T, Yildirim S, Akan M, et al. Can indications for lower limb replantation and revascularization be expanded with simultaneous free-flap transfer for limb salvage?[J]. J Reconstr Microsurg, 2004, 20(8):621-629.
19. Fang CL, Yang CS, Tang HC, et al. Successful replantation of amputated bilateral lower limbs[J]. Plast Reconstr Surg, 2012, 129(1):215e-217e.
20. Hierner R, Betz AM, Comtet JJ, et al. Decision making and results in subtotal and total lower leg amputations:reconstruction versus amputation[J]. Microsurgery, 1995, 16(12):830-839.
21. Atar E, Bachar GN, Bartal G, et al. Use of peripheral cutting balloon in the management of resistant benign ureteral and biliary strictures[J]. J Vasc Interv Radiol, 2005, 16(2 Pt 1):241-245.
22. Tang X, Guo W, Yang R, et al. Use of aortic balloon occlusion to decrease blood loss during sacral tumor resection[J]. J Bone Joint Surg Am, 2010, 92(8):1747-1753.
23. Ji T, Guo W, Tang XD, et al. Reconstruction of type Ⅱ+Ⅲ pelvic resection with a modular hemipelvic endoprosthesis:a finite element analysis study[J]. Orthop Surg, 2010, 2(4):272-277.
24. Tang X, Guo W, Ji T. Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis[J]. Arch Orthop Trauma Surg, 2011, 131(12):1609-1615.
25. Zhou Y, Duan H, Liu Y, et al. Outcome after pelvic sarcoma resection and reconstruction with a modular hemipelvic prostheses[J]. Int Orthop, 2011, 35(12):1839-1846.

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Clinical Evaluation of Lower Abdominal Aorta Balloon Occlusion in Pelvic or Sacral Tumor Resection

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