Department of Urology, University of Miami Miller School of Medicine, P.O. Box 016960 (M-814), Miami, FL 33101, USA.
World J Urol. 2012 Jun;30(3):379-83. doi: 10.1007/s00345-011-0746-4. Epub 2011 Aug 17.
To evaluate oncologic outcomes following the use of intraoperative cell salvage (IOCS) as a blood loss management strategy during open radical prostatectomy (RP).
We retrospectively reviewed all open retropubic RP cases performed by a single surgeon. Patients were identified who received IOCS blood and evaluated for an increased risk of biochemical recurrence (BCR) and overall mortality.
The study cohort consisted of 1,862 men, 395 (21.2%) of whom received IOCS blood. At a median follow-up of 47.0 months, men who received IOCS blood were not at an increased risk of BCR (P = 0.323) or all-cause mortality (P = 0.892). IOCS use did not confer an increased risk of BCR within any D'Amico preoperative risk category (low risk, P = 0.592; intermediate risk, P = 0.107; and high risk, P = 0.697).
IOCS is safe for the management of blood loss during RP. At long-term follow-up, IOCS use was not associated with an increased risk of BCR or death. While it remains preferable to avoid any form of blood transfusion, we advocate for the use of IOCS in place of allogeneic blood. These conclusions are drawn from our study of the largest and longest followed cohort patients who received IOCS blood during RP.
评估在开放性根治性前列腺切除术（RP）中使用术中血液回收（IOCS）作为失血量管理策略的肿瘤学结果。
我们回顾性分析了由一位外科医生进行的所有开放性耻骨后 RP 病例。确定了接受 IOCS 血液的患者，并评估了其生化复发（BCR）和总死亡率的风险增加。
研究队列包括 1862 名男性，其中 395 名（21.2%）接受了 IOCS 血液。在中位随访 47.0 个月时，接受 IOCS 血液的男性没有增加 BCR 的风险（P=0.323）或全因死亡率（P=0.892）。在任何 D'Amico 术前风险类别中，IOCS 的使用都不会增加 BCR 的风险（低危，P=0.592；中危，P=0.107；高危，P=0.697）。
IOCS 是 RP 失血管理的安全方法。在长期随访中，IOCS 的使用与 BCR 或死亡风险增加无关。虽然最好避免任何形式的输血，但我们提倡使用 IOCS 代替异体血液。这些结论是基于我们对接受 IOCS 血液的最大和随访时间最长的患者队列的研究得出的。
