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开放性部分肾切除术期间术中细胞回收输血的短期结局

Short-term Outcomes of Intraoperative Cell Saver Transfusion During Open Partial Nephrectomy.

作者信息

Lyon Timothy D, Ferroni Matthew C, Turner Robert M, Jones Cameron, Jacobs Bruce L, Davies Benjamin J

机构信息

Department of Urology, University of Pittsburgh, Pittsburgh, PA.

Department of Urology, University of Pittsburgh, Pittsburgh, PA.

出版信息

Urology. 2015 Dec;86(6):1153-8. doi: 10.1016/j.urology.2015.09.008. Epub 2015 Sep 24.

Abstract

OBJECTIVE

To determine whether transfusion using the Cell Saver system is associated with inferior outcomes in patients undergoing open partial nephrectomy.

METHODS

All patients who underwent open partial nephrectomy by a single surgeon (BJD) from August 2008 to April 2015 were retrospectively identified. Operations were grouped and compared according to whether they included a transfusion using the Cell Saver intraoperative cell salvage system.

RESULTS

Sixty-nine open partial nephrectomies in 67 patients were identified. Thirty-three procedures (48%) included a Cell Saver transfusion. Most tumors were clear cell renal cell carcinoma (62%) and stage T1a (68%). There were no significant differences between groups for any measured clinical or pathologic characteristics. Operations including a Cell Saver transfusion were longer (141 vs 108 minutes, P <.001), had significantly greater blood loss (600 vs 200 mL, P <.001), and had longer median renal ischemia times (15 vs 10 minutes, P = .03). There were no significant differences in postoperative complication rate (21% vs 17%, P = .83) or median length of hospital stay (3 vs 3 days, P = .09). At a median follow-up of 23 months (interquartile range: 8-42 months), 1 patient in the non-Cell Saver transfusion group had cancer recurrence. There was no metastatic progression or cancer-specific mortality in either group.

CONCLUSION

Cell Saver transfusion during open partial nephrectomy was not associated with inferior outcomes with short-term follow-up, and no patients developed metastatic disease.

摘要

目的

确定在接受开放性部分肾切除术的患者中,使用细胞回收系统进行输血是否与较差的预后相关。

方法

回顾性确定2008年8月至2015年4月由单一外科医生(BJD)进行开放性部分肾切除术的所有患者。根据手术是否包括使用细胞回收术中细胞回收系统进行输血进行分组和比较。

结果

共确定了67例患者的69例开放性部分肾切除术。33例手术(48%)包括细胞回收输血。大多数肿瘤为透明细胞肾细胞癌(62%)且为T1a期(68%)。两组在任何测量的临床或病理特征方面均无显著差异。包括细胞回收输血的手术时间更长(141分钟对108分钟,P <0.001),失血量显著更多(600毫升对200毫升,P <0.001),中位肾缺血时间更长(15分钟对10分钟,P =0.03)。术后并发症发生率(21%对17%,P =0.83)或中位住院时间(3天对3天,P =0.09)无显著差异。中位随访23个月(四分位间距:8 - 42个月)时,非细胞回收输血组有1例患者癌症复发。两组均无转移进展或癌症特异性死亡。

结论

开放性部分肾切除术中进行细胞回收输血在短期随访中与较差预后无关,且无患者发生转移性疾病。

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