Abdominal aortic balloon occluding in the pelvic and sacral tumor resection: An expert-based Delphi consensus

Massive bleeding remains a critical challenge during pelvic and sacral tumor resection. Over recent decades, abdominal aortic balloon occluding (AABO) has been increasingly utilized to control intraoperative bleeding. However, standardized protocols for its application in pelvic and sacral tumor resection remain lacking. This Delphi consensus aims to establish guidelines for AABO in this field based on the existing evidence and expertise.

A three-round Delphi process was conduct following a comprehensive literature review. Consensus was predefined as ≥85 % agreement among respondents. Forty-three experts from 19 regions of Chinese participated, including orthopedic surgeons, vascular surgeons, and anesthesiologists.

Consensus was achieved on eleven key variables: indications/contraindications, safety in elderly patients, preoperative preparation, balloon placement position, procedures of AABO, occlusion duration, measures to reduce complications related to AABO, acute femoral thrombosis management, intraoperative anesthesia monitoring indicators, and postoperative monitoring.

This expert-based Delphi consensus provides a framework for standardizing AABO application, enhancing surgical safety, and guiding future research.