Intraoperative Lower Abdominal Aorta Balloon Occluding in Pelvic or Sacral Tumor Resection_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Bin ¹ , ZHAO Jichun ¹ , MA Yukui ¹ , TU Chongqi ² , DUAN Hong ²

1.Department of Liver and Vascular Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;;
2.Department of Orthopedics Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding author：

Keywords：

Pelvic tumor; Sacral tumor; Bleeding; Abdominal aorta; Balloon occluding

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ObjectiveTo evaluate the clinical efficiency of balloon occlusion of the lower abdominal aorta in blood loss control during resections of pelvic or sacral tumor. MethodsFrom April 2006 to April 2010, 24 patients diagnosed as pelvic or sacral tumor in this hospital were collected. Balloon occlusion of the lower abdominal aorta to control blood loss was used in these cases. Balloon catheters were placed via femoral artery to occlude the abdominal aorta before operation. Resections of pelvic or sacral tumors were performed after occlusion of abdominal aorta, duration no longer than 60 min per occlusion, if repeated occlusions needed, 10－15 min release in between. 　Results Average operative time was 153 min (range 40－245 min) and average blood loss was 310 ml (range 200－650 ml) in this series, and the procedure helped in clearly identifying the surgical margin, neurovascular structures, and adjacent organs. The blood pressure were stable in all the cases. No postoperative renal function impairment was found in all the cases, no side injuries to adjacent organs was identified. One case complicated with thrombosis in iliac artery at same puncture side was successfully treated with catheter thrombectomy. ConclusionIntraoperative abdominal aorta balloon occluding in pelvic and sacral tumor surgical operation could reduce blood loss, and improve the safety of operation.

Citation： HUANG Bin ,ZHAO Jichun,MA Yukui,TU Chongqi,DUAN Hong. Intraoperative Lower Abdominal Aorta Balloon Occluding in Pelvic or Sacral Tumor Resection. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(6): 635-638. doi: Copy

1.	Masterson EL, Davis AM, Wunder JS, et al. Hindquarter amputation for pelvic tumors. The importance of patient selection [J]. Clin Orthop Relat Res, 1998, (350): 187194.
2.	Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum [J]. Clin Orthop Relat Res, 1993, (291): 215221.
3.	李鼎锋, 崔秋, 乐守玉, 等. 腹主动脉血流阻断技术在行骨盆、骶骨肿瘤切除中的临床评价 [J]. 中国癌症杂志, 2003, 13(3): 259262.
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5.	北京大学人民医院骨与软组织肿瘤治疗中心. 骶骨肿瘤的手术治疗 [C]. 北京: 北京国际骨与软组织肿瘤研讨会, 2003: 28.
6.	Ozaki T, Liljenqvist U, Halm H, et al. Giant cell tumor of the spine [J]. Clin Orthop Relat Res, 2002, (401): 194201.
7.	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.
8.	Wirbel RJ, Roth R, Schulte M, et al. Preoperative embolization in spinal and pelvic metastases [J]. J Orthop Sci, 2005, 10(3): 253257.
9.	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.
10.	梁斌, 韦敏克, 李宏宇, 等. 动脉栓塞对骨盆肿瘤手术疗效的影响 [J]. 中国矫形外科杂志, 2006, 14(11): 831833.
11.	Wuisman P, Lieshout O, Sugihara S, et al. Total sacrectomy and reconstruction: oncologic and functional outcome [J]. Clin Orthop Relat Res, 2000, (381): 192203.
12.	Lackman RD, Khoury LD, Esmail A, et al. The treatment of sacral giantcell tumours by serial arterial embolisation [J]. J Bone Joint Surg Br, 2002, 84(6): 873877.
13.	Lin PP, Guzel VB, Moura MF, et al. Longterm followup of patients with giant cell tumor of the sacrum treated with selective arterial embolization [J]. Cancer, 2002, 95(6): 13171325.
14.	O’Donnell ME, Badger SA, Makar RR, et al. Techniques in occluding the aorta during endovascular repair of ruptured abdominal aortic aneurysms [J]. J Vasc Surg, 2006, 44(1): 211215.
15.	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.
16.	Rutherford R. Vascular surgery [M]. Philadelphia: Saunders, 2000: 959970.
17.	Ullmark G, Hovelius L, Strindberg L, et al. Reduced bleeding through temporary balloon occlusion in hip and knee revision surgery [J]. Acta Orthop Scand, 2000, 71(1): 5154.
18.	潘水章, 何登伟. 低位腹主动脉间歇性阻断技术的临床应用 [J]. 临床骨科杂志, 2000, 3(3): 183184.
19.	Silberzweig JE, Marin ML, Hollier LH, et al. Balloonexpandable common iliac artery occluder device for endovascular aneurysm repair [J]. Vasc Surg, 2001, 35(4): 263271.
20.	唐顺, 董森, 郭卫, 等. 腹主动脉球囊阻断控制骶骨肿瘤切除术中出血的效果 [J]. 中国脊柱脊髓杂志, 2009, 19(2): 8589.
21.	徐懋, 张耕, 韦峰, 等. 球囊阻断低位腹主动脉在腰骶骨肿瘤手术中的应用 [J]. 中国微创外科杂志, 2010, 10(2): 147149.
22.	米川, 马忠泰, 卢海霖, 等. 球囊导管阻断动脉控制肿瘤术中出血的可行性研究 [J]. 中华骨科杂志, 2005, .25(5): 280283.
23.	Tang X, Guo W, Yang R, et al. Risk factors for blood loss during sacral tumor resection [J]. Clin Orthop Relat Res, 2009, 467(6): 15991604.
24.	路小勇, 崔现平, 张志. 不同控制出血方法在骶骨肿瘤切除术中的应用价值比较 [J]. 中国脊柱脊髓杂志, 2007, 17(12): 899903.
25.	马泽民, 吕国华, 王冰, 等. 腹主动脉阻断与髂内动脉结扎控制出血在骶骨肿瘤切除手术中的应用比较研究 [J]. 中国现代医学杂志, 2004, 14(2): 3335.
26.	张晓庆, 刘健慧, 郁庆. 骨盆和盆腔肿瘤无血手术技术的临床应用 [J]. 同济大学学报(医学版), 2008, 29(2): 5356.
27.	江晨, 邵性兴, 刘希洪. 腹主动脉阻断法在盆腔手术中应用3例体会 [J]. 中国普外基础与临床杂志, 1998, 5(6): 382.

1. Masterson EL, Davis AM, Wunder JS, et al. Hindquarter amputation for pelvic tumors. The importance of patient selection [J]. Clin Orthop Relat Res, 1998, (350): 187194.
2. Turcotte RE, Sim FH, Unni KK. Giant cell tumor of the sacrum [J]. Clin Orthop Relat Res, 1993, (291): 215221.
3. 李鼎锋, 崔秋, 乐守玉, 等. 腹主动脉血流阻断技术在行骨盆、骶骨肿瘤切除中的临床评价 [J]. 中国癌症杂志, 2003, 13(3): 259262.
4. 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.
5. 北京大学人民医院骨与软组织肿瘤治疗中心. 骶骨肿瘤的手术治疗 [C]. 北京: 北京国际骨与软组织肿瘤研讨会, 2003: 28.
6. Ozaki T, Liljenqvist U, Halm H, et al. Giant cell tumor of the spine [J]. Clin Orthop Relat Res, 2002, (401): 194201.
7. 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.
8. Wirbel RJ, Roth R, Schulte M, et al. Preoperative embolization in spinal and pelvic metastases [J]. J Orthop Sci, 2005, 10(3): 253257.
9. 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.
10. 梁斌, 韦敏克, 李宏宇, 等. 动脉栓塞对骨盆肿瘤手术疗效的影响 [J]. 中国矫形外科杂志, 2006, 14(11): 831833.
11. Wuisman P, Lieshout O, Sugihara S, et al. Total sacrectomy and reconstruction: oncologic and functional outcome [J]. Clin Orthop Relat Res, 2000, (381): 192203.
12. Lackman RD, Khoury LD, Esmail A, et al. The treatment of sacral giantcell tumours by serial arterial embolisation [J]. J Bone Joint Surg Br, 2002, 84(6): 873877.
13. Lin PP, Guzel VB, Moura MF, et al. Longterm followup of patients with giant cell tumor of the sacrum treated with selective arterial embolization [J]. Cancer, 2002, 95(6): 13171325.
14. O’Donnell ME, Badger SA, Makar RR, et al. Techniques in occluding the aorta during endovascular repair of ruptured abdominal aortic aneurysms [J]. J Vasc Surg, 2006, 44(1): 211215.
15. 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.
16. Rutherford R. Vascular surgery [M]. Philadelphia: Saunders, 2000: 959970.
17. Ullmark G, Hovelius L, Strindberg L, et al. Reduced bleeding through temporary balloon occlusion in hip and knee revision surgery [J]. Acta Orthop Scand, 2000, 71(1): 5154.
18. 潘水章, 何登伟. 低位腹主动脉间歇性阻断技术的临床应用 [J]. 临床骨科杂志, 2000, 3(3): 183184.
19. Silberzweig JE, Marin ML, Hollier LH, et al. Balloonexpandable common iliac artery occluder device for endovascular aneurysm repair [J]. Vasc Surg, 2001, 35(4): 263271.
20. 唐顺, 董森, 郭卫, 等. 腹主动脉球囊阻断控制骶骨肿瘤切除术中出血的效果 [J]. 中国脊柱脊髓杂志, 2009, 19(2): 8589.
21. 徐懋, 张耕, 韦峰, 等. 球囊阻断低位腹主动脉在腰骶骨肿瘤手术中的应用 [J]. 中国微创外科杂志, 2010, 10(2): 147149.
22. 米川, 马忠泰, 卢海霖, 等. 球囊导管阻断动脉控制肿瘤术中出血的可行性研究 [J]. 中华骨科杂志, 2005, .25(5): 280283.
23. Tang X, Guo W, Yang R, et al. Risk factors for blood loss during sacral tumor resection [J]. Clin Orthop Relat Res, 2009, 467(6): 15991604.
24. 路小勇, 崔现平, 张志. 不同控制出血方法在骶骨肿瘤切除术中的应用价值比较 [J]. 中国脊柱脊髓杂志, 2007, 17(12): 899903.
25. 马泽民, 吕国华, 王冰, 等. 腹主动脉阻断与髂内动脉结扎控制出血在骶骨肿瘤切除手术中的应用比较研究 [J]. 中国现代医学杂志, 2004, 14(2): 3335.
26. 张晓庆, 刘健慧, 郁庆. 骨盆和盆腔肿瘤无血手术技术的临床应用 [J]. 同济大学学报(医学版), 2008, 29(2): 5356.
27. 江晨, 邵性兴, 刘希洪. 腹主动脉阻断法在盆腔手术中应用3例体会 [J]. 中国普外基础与临床杂志, 1998, 5(6): 382.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Intraoperative Lower Abdominal Aorta Balloon Occluding in Pelvic or Sacral Tumor Resection

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