Correlations Between Preoperative Radiographic Vascular Involvement of Abdominal/Pelvic Neuroblastomas on Computed Tomography and Intraoperative Vascular Injuries: Experience From a Tertiary Children's Hospital

Abstract

This research examines the prevalence and occurrence of intraoperative vascular injuries in abdominal or pelvic neuroblastomas. It also investigates the correlations between preoperative radiographic vascular involvement on computed tomography (CT) and intraoperative vascular injuries in abdominal or pelvic neuroblastomas. This study enrolled 297 patients with abdominal or pelvic neuroblastomas. The relationships between neuroblastomas and adjacent arteries on preoperative CT were categorized as no contact, contact (less than 50% of vessel circumference involved), partial encasement (less than 100% of vessel circumference involved), and total encasement (100% of vessel circumference involved). Similarly, the relationships between neuroblastomas and adjacent veins on preoperative CT were categorized as no compression, flattened with a visible lumen, and flattened with an invisible lumen. Furthermore, the correlations between preoperative radiographic vascular involvement of neuroblastomas and intraoperative vascular injuries were analyzed. A total of 61 patients had intraoperative vascular injuries, among which 76 vessels suffered injuries. Venous injuries (66/76, 86.84%) were more common than arterial injuries (10/76, 13.16%). Moreover, venous injuries frequently occurred in the inferior vena cava (32/66, 48.48%), renal veins (19/66, 28.79%), and iliac veins (8/66, 12.12%). All the injured arteries exhibited a total encasement on preoperative CT, and no injury occurred when the arteries were contacted or partially encased. In total, 87.88% (58/66) of injured veins were flattened with a visible lumen on preoperative CT, whereas only 12.12% (8/66) of the injured veins were flattened with an invisible lumen. Intraoperative injuries to veins occur more frequently than that to arteries in abdominal or pelvic neuroblastomas. Importantly, intraoperative injuries to veins may occur even if the veins are flattened with a visible lumen.