(P 379) KEY POINTS OF ANESTHESIA MANAGEMENT AND PROGNOSIS ANALYSIS OF ELDERLY PATIENTS WITH RETROPERITONEAL TUMOR

Objective: To summarize and analyze the key points of anesthesia management for elderly patients undergoing retroperitoneal tumor resection and its impact on patient prognosis, providing a reference for perioperative management of such patients.

Methods: Retrospectively analyze the anesthesia management of elderly patients aged ≧65 years who underwent retroperitoneal tumor resection under general anesthesia at Peking University International Hospital from January 2015 to December 2022, and analyze the influencing factors of hospitalization duration, postoperative hospitalization duration, and postoperative complication classification.

Results: A total of 248 patients were included in this study, including 136 males and 112 females with an average age of 69.7±4.4 years. Preoperative ASA classification was 134 cases of grade II, 106 cases of grade III, and 8 cases of grade IV. 129 patients (52.0%) had secondary or more surgeries, with a duration of surgery and anesthesia of 287.2±132.0 minutes and 362.9±135.9 minutes, respectively. Target-oriented fluid management was used during surgery, and blood products were supplemented according to the indications for blood transfusion. After surgery, 198 patients (79.8%) were extubated and returned to the ward, while 50 patients (20.2%) were admitted to the ICU for further treatment. The length of hospital stay was 38.0±21.9 days, and the length of postoperative hospitalization was 26.5±20.7 days. Multiple linear regression analysis showed that the length of hospitalization and postoperative hospitalization were positively correlated with the use of prothrombin complex concentrate during surgery and the level of blood glucose at the end of surgery. There were 44 cases of severe complications (Clavien-Dindo grade ≥Ⅲa) after surgery, including 4 deaths due to toxic shock, hemorrhagic shock, and multiple organ failure. Multiple linear regression analysis showed that male gender, intraoperative infusion of colloidal solution, and postoperative lactate level were independent risk factors for severe complications after surgery.

Conclusion: For elderly patients undergoing retroperitoneal tumor resection, comprehensive preoperative preparation and more precise anesthesia management are required. During the operation, avoid the infusion of artificial colloidal fluids, carefully administer prothrombin complex concentrate, and pay attention to male patients, blood glucose and lactate levels after surgery. Targeted treatment can help improve patient prognosis.