Use of Aortic Balloon Occlusion to Decrease Blood Loss During Sacral Tumor Resection

Abstract

Aortic balloon occlusion has been introduced into sacral tumor surgery to reduce extensive hemorrhage. The purposes of this retrospective study were to determine the efficacy of aortic balloon occlusion in decreasing intraoperative and postoperative blood losses and to analyze the complications of this technique. The cases of 215 patients in whom a sacral tumor had been treated surgically between 1997 and 2009 were studied retrospectively. Ninety-five patients who had had sacral tumor resection without aortic balloon occlusion were compared with 120 patients in whom aortic balloon occlusion had been carried out during the tumor resection. The demographic data, possible factors influencing hemorrhage, and total blood loss volume (including intraoperative and postoperative volumes) were determined with a review of the medical records and compared between the two groups. There were no significant differences between the two groups in terms of the demographic data, grade of malignancy, tumor blood supply, location of the tumor, percentage of patients who had a recurrent tumor or preoperative radiation, surgical approach, or type of resection. The patients with aortic balloon occlusion had a larger mean tumor volume, more frequently had a sacral reconstruction, and had a longer mean operative time; however, their mean total (2963 mL) and intraoperative (2236 mL) blood loss volumes were lower than those of the patients without occlusion (4337 and 3935 mL, respectively) (p < 0.001). Complications related to aortic balloon occlusion included femoral artery embolism in three patients and hematoma formation at the puncture site in five. Aortic balloon occlusion decreases the total and intraoperative blood loss volumes in patients treated with sacral tumor surgery who require extensive dissection. There is a low rate of balloon-related complications.