Relationship between temporary abdominal aortic occlusion and complications after pelvic tumor resection

doi:10.3877/cma.j.issn.1674-0785.2024.12.001

Abstract

Abstract:

Objective

To analyze the complications of temporary abdominal aortic balloon occlusion in pelvic tumor resection surgery and the risk factors affecting the occurrence of severe complications.

Methods

Pelvic tumor patients who underwent surgery at the Department of Retroperitoneal Tumor Surgery, Peking University International Hospital from January 2014 to June 2024 were collected.All the patients used the temporary abdominal aortic occlusion balloon during the operation. According to the severity of postoperative complications (based on the Clavien-Dindo classification), the patients were divided into a severe complication group (complications≥grade 3) and a non-severe complication group (no complications or complications≤grade 2). The occurrence of postoperative complications in all patients was statistically analyzed, and by comparing the differences in clinical and pathological data between the two groups, the possible risk factors related to the occurrence of severe complications were explored.

Results

A total of 25 patients were included, of which 21 achieved R0/R1 resection. A total of 6 patients experienced severe complications (≥grade 3) (24%), all of whom recovered and were discharged after treatment, with no perioperative deaths. There were no significant differences between patients with severe complications and those without in terms of gender, age, tumor status, combined organ resection, intraoperative bleeding and transfusion volume, operation time, number of occlusions, or postoperative hospital stay (P＞0.05). The cumulative occlusion time (P=0.001) and the longest single occlusion time (P=0.032) were longer in the group with severe complications.

Conclusion

Prolonged occlusion time and longer single occlusion time may be risk factors for severe complications after the use of temporary abdominal aortic occlusion balloon in pelvic tumor resection surgery. By reducing intraoperative occlusion time, it is possible to reduce the occurrence of severe postoperative complications while minimizing bleeding.

Key words: Aorta balloon occlusion, Pelvic tumor, Bleeding, Complications

Peng Zhao, Maosheng Tang, Wenjie Li, Shibo Liu, Boyuan Zou, Chengli Miao, Haicheng Gao. Relationship between temporary abdominal aortic occlusion and complications after pelvic tumor resection[J]. Chinese Journal of Clinicians(Electronic Edition), 2024, 18(12): 1075-1080.

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URL: https://zhlcyszz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0785.2024.12.001

https://zhlcyszz.cma-cmc.com.cn/EN/Y2024/V18/I12/1075

Figures/Tables 4

项目	发生严重并发症组	无严重并发症组	P 值
性别[ 例（%）]			0.258
男性	1（16.7）	8（42.1）
女性	5（83.3）	11（57.9）
年龄[ 岁， $\overset{ˉ}{x}$ ±s]	50±16	51±13	0.848
ASA 评分[ 分， $\overset{ˉ}{x}$ ±s]			0.566
2	3	7
3	3	12
BMI（kg/m2， $\overset{ˉ}{x}$ ±s）	20.7±3.7	23.4±3.1	0.310
原发肿瘤			0.122
是	1	10
否	5	9
肿瘤最大径（cm， $\overset{ˉ}{x}$ ±s）	16.8±6.4	14.0（9.1～24.6）	0.926
手术时间（min， $\overset{ˉ}{x}$ ±s）	404±74	328±110	0.080
根治程度[ 例（%）]			0.959
R0/R1	5（83.3）	16（84.2）
R2	1（16.7）	3（15.8）
联合脏器切除[ 例（%）]			0.876
是	4（66.7）	12（63.2）
否	2（33.3）	7（36.8）
估计出血量（ml， $\overset{ˉ}{x}$ ±s）	2067±1048	1763±893	0.492
术中红细胞输注量（U， $\overset{ˉ}{x}$ ±s）	15±7	11±6	0.201
术后住院时间（d， $\overset{ˉ}{x}$ ±s）	26±18	21±13	0.511
肿瘤类型			0.759
平滑肌肉瘤	2	6
脂肪肉瘤	1	3
孤立性纤维性肿瘤	1	3
恶性外周神经鞘膜瘤	0	2
神经鞘瘤	0	1
副神经节瘤	0	1
PEComa	0	1
软骨肉瘤	0	1
生殖细胞肿瘤	1	0
不明确	1	1

项目	发生严重并发症组	无严重并发症组	P 值
性别[ 例（%）]			0.258
男性	1（16.7）	8（42.1）
女性	5（83.3）	11（57.9）
年龄[ 岁， $\overset{ˉ}{x}$ ±s]	50±16	51±13	0.848
ASA 评分[ 分， $\overset{ˉ}{x}$ ±s]			0.566
2	3	7
3	3	12
BMI（kg/m2， $\overset{ˉ}{x}$ ±s）	20.7±3.7	23.4±3.1	0.310
原发肿瘤			0.122
是	1	10
否	5	9
肿瘤最大径（cm， $\overset{ˉ}{x}$ ±s）	16.8±6.4	14.0（9.1～24.6）	0.926
手术时间（min， $\overset{ˉ}{x}$ ±s）	404±74	328±110	0.080
根治程度[ 例（%）]			0.959
R0/R1	5（83.3）	16（84.2）
R2	1（16.7）	3（15.8）
联合脏器切除[ 例（%）]			0.876
是	4（66.7）	12（63.2）
否	2（33.3）	7（36.8）
估计出血量（ml， $\overset{ˉ}{x}$ ±s）	2067±1048	1763±893	0.492
术中红细胞输注量（U， $\overset{ˉ}{x}$ ±s）	15±7	11±6	0.201
术后住院时间（d， $\overset{ˉ}{x}$ ±s）	26±18	21±13	0.511
肿瘤类型			0.759
平滑肌肉瘤	2	6
脂肪肉瘤	1	3
孤立性纤维性肿瘤	1	3
恶性外周神经鞘膜瘤	0	2
神经鞘瘤	0	1
副神经节瘤	0	1
PEComa	0	1
软骨肉瘤	0	1
生殖细胞肿瘤	1	0
不明确	1	1

组别	阻断次数（例）		累计阻断时间（min）	单次最长阻断时间（min）
组别	1	≥ 2	累计阻断时间（min）	单次最长阻断时间（min）
无严重并发症组	8	11	73±52	46±19
有严重并发症组	0	6	166±41	65±12
χ ²/t	-		-3.987	-2.29
P 值	0.07		0.001	0.032

患者编号	并发症	治疗	转归
1	下肢深静脉血栓形成	下腔静脉滤网置入	痊愈出院
2	下肢深静脉血栓形成	下腔静脉滤网置入	痊愈出院
3	股动脉血栓形成	股动脉切开取栓	痊愈出院
4	股动脉血栓形成	股动脉切开取栓	痊愈出院
5	直肠吻合口瘘	回肠造口术	痊愈出院
6	急性脑梗塞	溶栓和抗凝治疗	痊愈出院

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