Department of Obstetrics and Gynecology, Alexandra Hospital, School of Medicine, University of Athens, Greece.
World J Surg Oncol. 2011 Nov 3;9:142. doi: 10.1186/1477-7819-9-142.
This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays, as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products, putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative, intraoperative and postoperative measures are required, such as optimization of red blood cell mass, adequate preoperative plan and invasive hemostatic procedures, assisting anesthetic techniques, individualization of anemia tolerance, autologous blood donation, normovolemic hemodilution, intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies, and not only on demand of the patient, in the field of gynecologic oncology with the use of drugs, devices and surgical-medical techniques.
本文旨在概述妇科肿瘤学领域中无血手术中使用的替代措施和干预措施，并展示其有效性。如今，越来越多的患者对异体输血相关潜在风险表示担忧，因此实施无血手术的理念似乎越来越被接受。越来越多的医疗机构似乎成功地采用了各种方法，使所有接受妇科恶性肿瘤治疗的患者的血液使用量降至最低。需要采取术前、术中和术后措施，如优化红细胞量、充分的术前计划和侵入性止血措施、辅助麻醉技术、个体化贫血耐受、自体输血、等容血液稀释、术中细胞回收和控制失血的药物等。具有丰富经验的人员应制定个体化管理计划，采用多学科团队方法，制定非血液管理策略，不仅应满足患者的需求，还应在妇科肿瘤学领域中使用药物、器械和手术-医疗技术。
