J Anesth Perioper Med. 2018;6(1):17-22. https://doi.org/10.24015/ebcmed.japm.2017.0029

Intra-Aortic Balloon Occlusion for Pelvic and Sacrum Tumors: A Case Series

Kai Sun1, Yang-Fan Huo2, Yong Xu1, Feng-Jiang Zhang1, Shui Yu1, Zhen-Feng Zhou1, Li-Na Yu1, and Min Yan1

From 1Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China; 2Weifang Medical University,Weifang, China.

Correspondence to Dr. Min Yan at zryanmin@zju.edu.cn.

EBCMED ID: ebcmed.japm.2017.0029 DOI: 10.24015/ebcmed.japm.2017.0029


Abstract

Background
The purpose of this study is to investigate feasibilities of intra-aortic balloon occlusion (IABO) for pelvic and sacrum tumors, focusing on the advantages and precautions of the technique.

Methods
From January 2010 to December 2013, among all patients with sacrum or pelvic tumor, 46 underwent surgery adjuvant with IABO. We retrospectively reviewed the medical records of these patients, including characteristics, intraoperative hemorrhage, transfusion, serum potassium, arterial lactic acid, postoperative complication, tumor recurrence or metastasis at a follow-up of 28.2 months.

Results
Balloons for 46 patients were successfully placed, and the average intraoperative hemorrhage was 1.8 (1.2- 3.0) l. Intraoperatively, arterial lactic acid increased from baseline (1.69±0.68) mmol/l to (2.11±0.82) mmol/l (P=0.17) during occlusion and (3.50±2.70) mmol/l (P=0.02) after deflation. While serum potassium concentration showed a trend of increase, but the change was not significant. Application of the technique helped create a bloodless surgical field and shorten the operative time. 9 patients regained normal defecation, while 2 patients with preoperative numbness of perineum developed new onset urinary and fecal incontinence after surgery. Postoperatively, 5 patients developed wound infection, 1 patient developed lower limb weakness, and 1 patient developed cerebrospinal leak. During 28.2 months' followup, 5 recurrences and 2 metastases occurred.

Conclusions
IABO might be a choice to reduce intraoperative bleeding, create a clear view of the anatomical structures, shorten the operative time and limit postoperative complication in resection of pelvic and sacrum tumor. Nevertheless, anesthesiologists and surgeons should be sensitive to hemodynamic parameters, electrolyte balance as well as acid- base balance during the procedure, especially after deflation of the balloon. (Funded by the Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, China.)

Article Type
Original Article

Declaration of Interests
The authors declare no other conflicts of competing interest for this work.

Acknowledgements
This study was funded by the Department of Anesthesiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.

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