Evaluation Of The Effect Of Low Abdominal Aorta Balloon Occlusion On Reducing Blood Loss During Giant Sacral Tumor Resection

Objective To evaluate the effect of low abdominal aortic balloon occlusion on reducing blood loss during giant sacral tumor resection.Methods The clinical data of 24 cases of giant sacral tumor(GST)admitted from June 2012 to October 2017 in our department were retrospectively analyzed.Among them,17 patients underwent posterior sacral tumor resection under low abdominal aortic balloon occlusion,and 7patients underwent posterior sacral tumor resection under internal iliac artery embolization.The intraoperative blood loss and transfusion volume,postoperative blood transfusion volume and drainage volume,postoperative Frankel grade and Karnofsky score improvement,postoperative hospital stay and complications were observed and compared.Results In balloon group,the operation time was(230.47±100.02)min,intraoperative bleeding was(761.76±903.21)ml,intraoperative blood transfusion was(494.12±794.10)ml,postoperative blood transfusion was(70.59±211.44)ml.The average postoperative hospital stay was(14.24±9.57)d,the average drainage volume was(990.35±1139.42)ml,and the average extubation time was(7.00±3.02)d.In the embolization group,the operation time was(255.71±41.68)min,the intraoperative bleeding was(1642.86±596.82)ml,the intraoperative blood transfusion was(885.71±630.95)ml,and the postoperative blood transfusion was(435.71±280.94)ml.The average postoperative hospital stay was(31.00±17.06)d,the average drainage volume was(1018.71±472.79)ml,and the average extubation time was(14.71±4.23)d.In terms of intraoperative bleeding,postoperative blood transfusion and extubation time,abdominal aortic balloon-assisted sacral tumor resection was significantly better than that of internal iliac artery embolization(P < 0.05).Of the 17 patients in the balloon group,7 patients had complications,including 1 case of incision fat liquefaction,2 cases of subcutaneous effusion,2 cases of incision infection,1 case of long-term indwelling catheterization of ureteral injury during operation and 1 case of delirium after operation.all improved after dressing change,debridement and suture and symptomatic treatment.The average follow-up was 21 months(6-41months),3 cases died.Complications occurred in 4 of the 7 patients in the embolization group,including 2 cases of incision infection,1 case of subcutaneous effusion and 1 case of nervous symptoms of both lower extremities,which were improved after symptomatic treatment.The average follow-up period was 20 months(6-39 months),and 4 cases died.The Frankel grade of the patients in the balloon group was significantly improved compared with that before operation,but there was no significant difference in the Frankel grade before and after embolization in the embolization group.The KPS score after operation in the balloon group was significantly better than that before operation,but there was no significant difference between the embolization group and the embolization group before and after operation.Conclusion The low abdominal aortic balloon occlusion can effectively reduce the amount of blood loss,postoperative blood transfusion and postoperative extubation time in the resection of giant sacral tumor,which has a positive impact on the prognosis of patients,so it is worth popularizing in clinic.