Reduction of blood loss during extensive pelvic procedures by aortic clamping--a preliminary report.
OBJECTIVE
The aim was to determine the effect of intraoperative aortic clamping during extensive pelvic procedures on blood loss, operative time, and morbidity.


METHODS
Thirteen women with ovarian cancer, 1 with cervical cancer, and 1 with an extensive pelvic sarcoma had their aortas completely occluded with a vascular clamp before the pelvic phases of their operations. Heparin and protamine reversal were used.


RESULTS
Patients requiring en bloc excision of the internal reproductive organs, pelvic peritoneum, and recto-sigmoid colon in the context of a cytoreductive operation had a median estimated total blood loss of 650 ml (range 200 to 3500), a median of 2 units (range 0 to 8) of blood transfused, and a median total operative time of 155 min (range 90 to 280). There were no complications due to the aortic clamping.


CONCLUSIONS
Most procedures were completed with a less than anticipated blood loss and operative time. Clamping of the aorta may potentially diminish blood loss, operative time, and the incidence of transfusion-related morbidity associated with extensive pelvic operations. Intraoperative aortic clamping merits further investigation.
Eisenkop
Scott M
SM
Women's Cancer Center, Encino-Tarzana, California 91356, USA. dobsnccats@earthlink.net
Spirtos
Nick M
NM
Lin
Wei-Chien Michael
WC
Gross
Gary M
GM
D000328:Adult; D000368:Aged; D001013:Aorta, Thoracic; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery; D010385:Pelvic Exenteration / Q000379:methods; D010386:Pelvic Neoplasms / Q000601:surgery*; D012509:Sarcoma / Q000601:surgery; D013525:Surgical Instruments; D002583:Uterine Cervical Neoplasms / Q000601:surgery