Perioperative anesthetic management in patients undergoing resection of giant abdominal masses: a retrospective analysis of 21 cases

Objective: To summarize perioperative anesthetic management in patients undergoing resection of giant abdominal masses. Methods: Perioperative data from 21 patients who underwent resection of giant abdominal masses between January 2016 and December 2024 were retrospectively analyzed. Descriptive statistical methods and stratified comparative analyses were applied to evaluate perioperative characteristics and outcomes. Results: The maximum tumor diameter ranged from 15 to 50 cm. Tumors originated from the abdominal wall in 8 cases (38.10%), the abdominopelvic cavity in 6 cases (28.57%), and the retroperitoneum in 7 cases (33.33%). Pathological diagnoses predominantly included malignant tumors in 11 cases (52.38%) and borderline tumors in 7 cases (33.33%). General anesthesia was administered to all 21 patients, with single-lumen endotracheal intubation used in 16 cases (76.2%). Intraoperative monitoring consisted of invasive arterial pressure monitoring in 16 cases (76.2%), central venous pressure monitoring in 15 cases (71.4%), and FloTrac-based cardiac output monitoring in 8 cases (38.1%). Operative duration ranged from 110 to 440 min, and massive hemorrhage (≥ 1,000 mL) occurred in 57.1% of patients. Postoperative intensive care unit (ICU) stay ranged from 0 to 12 days, while postoperative hospital stay ranged from 7 to 58 days. Stratified analyses indicated that patients with retroperitoneal masses presented with higher preoperative American Society of Anesthesiologists (ASA) physical status classification, larger tumor diameter, and longer ICU and hospital stays. Patients with malignant tumors were older and demonstrated higher ASA classification, longer operative duration, and prolonged ICU stay. Conclusion: Anesthetic management for resection of giant abdominal masses requires individualized strategies. Preoperative multidisciplinary consultation and interventional embolization may reduce surgical risk. Intraoperative advanced hemodynamic monitoring and meticulous volume management warrant particular attention.