The clinical effectiveness and safety of Zone Ⅲ REBOA for sacropelvic tumors resection in patients older than 70 years: A prospective propensity score- matched study

Abstract

Abstract Background REBOA is a method used to manage bleeding during surgeries involving sacral and pelvic tumors. Nevertheless, there is a lack of studies regarding the use of REBOA in the elderly demographic.The aim of this research was to investigate the efficiency and security of Zone Ⅲ REBOA in performing sacral and pelvic tumor removal surgeries on patients aged more than 70 years. Methods Between 2020 and 2021, a prospective analysis using case-control methods was conducted. A group of patients, referred to as Group A, who were over the age of 70 years, were identified and then paired with a comparable group of patients, known as Group B, who were under the age of 60 years. Propensity score matching was used to match two groups in a 1:2 ratio based on sex, BMI, lesion site, preoperative hemoglobin (Hb), preoperative blood platelet count, and occlusion time. Continuous monitoring of physiological parameters was conducted, and blood samples were collected at consistent intervals. Results Out of the 188 individuals, a total of 51 patients (Group A: 34 patients; Group B: 17 patients) were successfully paired. By implementing REBOA, the average amount of blood lost was merely 1545 ml (SD, 1018; range, 200–4500), while the average duration of the entire operation was 211 minutes (SD, 87; range, 85–500). Additionally, the mean duration of occlusion was 66 minutes (SD, 26; range, 10–135). Experiments were conducted to compare group A and group B. No notable variations were observed in terms of demographics, systolic blood pressure (SBP), pH levels, lactate levels, blood creatinine levels, potassium levels, and calcium levels at the baseline. Additionally, during the deflation of the REBOA, the laboratory tests, which included pH, lactate potassium, calcium, and blood creatinine, showed no significant difference (P > 0.05) as well. Conclusion In conclusion, the findings of this research indicate that patients over the age of 70 years can achieve satisfactory hemodynamic and metabolic stability with Zone Ⅲ REBOA. Level of evidence: Therapeutic study, Level III.