Abdominal aortic balloon occlusion during the resection of pelvic tumors and management for related vascular complications / 中华普通外科杂志

ABSTRACT

Objective To evaluate abdominal aortic balloon occlusion during pelvic tumors surgery and mamagement of related vascular complications. Methods We retrospectively analyze the clinical data of 265 pelvic tumor cases from December 2005 to April 2010.Before pelvic tumor operation,we place a sheath by Seldinger maneuvre in common femoral artery and send a balloon catheter in the abdominal aorta below the level of renal artery.The balloon catheter occluded the blood flow below the level of renal artery totally during the time of removing the tumors.After the procedure,we pull the balloon catheter out and normally retain the sheath for 6 hours. Results The procedure was successful in all cases and the average time of abdominal aorta blockade was (66 ± 4) min.There was no abdominal aortic rupture and acute renal dysfunction.Emergency angiography was performed on the operative region to diagnose the cause of massive bleeding after the open surgery in 6 cases.Among them,3 cases underwent embolization of internal iliac artery to stop bleeding and 1 case underwent embolization of lumber artery.Small covered stent was deployed in the common iliac artery to stop bleeding in 2 cases.Thrombosis of femoral artery at the puncture site occurred in 6 cases and bilateral thrombosis developed in 1 case. Blood flow was restowed to the femoral artery by open thrombectomy.Pseudoaneurysm formation around the puncture point occured in 2 cases and they underwent open surgical repair,then recovered well. Conclusions Balloon catheter occlusion of abdominal aorta is an effective method to control the hemorrhage in the pelvic tumors' operation.