Beynon J, Davies P W, Billings P J, Channer J L, Protheroe D, Umpleby H C, Mortensen N J, Williamson R C
Department of Surgery, Bristol Royal Infirmary, United Kingdom.
Dis Colon Rectum. 1989 Nov;32(11):975-9. doi: 10.1007/BF02552276.
A retrospective study was conducted on 519 patients undergoing curative resection for colorectal carcinoma between 1969 and 1980. Recurrence was diagnosed in 214 patients (41.2 percent), 179 of whom (34.5 percent) had received blood transfusions and 35 of whom (6.7 percent) had not (P less than .001). Exclusion of the right-sided colonic tumors still showed that recurrence was more common in transfused than nontransfused patients (135 [47.2 percent] vs. 25 [22.5 percent]; P less than .001). Recurrence in patients transfused only during surgery (N = 201) was higher than in nontransfused patients (P less than .001) and, similarly, all patients transfused during surgery (N = 297) had an increased risk (P less than .001). Among patients with rectal cancer, transfusion increased the risk of recurrence in those treated by abdominoperineal resection (P less than .02), but this was not the case in those treated by sphincter-saving resection (P = .2). Hierarchical log linear analysis of all dependent factors (Dukes' stage, histologic grade, age, sex, site, elective, or emergency procedure) showed that Dukes' stage and blood transfusion had the most significant effects on the development of recurrence (chi 2 = 54.04, df = 6, P less than .0001 and chi 2 = 13.93, df = 3, P less than .003). The risk of recurrence following curative surgery for colorectal cancer is markedly increased by blood transfusion on the day of operation.
对1969年至1980年间接受结直肠癌根治性切除术的519例患者进行了一项回顾性研究。214例患者（41.2%）被诊断为复发，其中179例（34.5%）接受过输血，35例（6.7%）未接受过输血（P<0.001）。排除右侧结肠肿瘤后仍显示，接受输血的患者比未接受输血的患者复发更常见（135例[47.2%]对25例[22.5%]；P<0.001）。仅在手术期间接受输血的患者（N=201）的复发率高于未接受输血的患者（P<0.001），同样，所有在手术期间接受输血的患者（N=297）复发风险均增加（P<0.001）。在直肠癌患者中，输血增加了经腹会阴切除术患者的复发风险（P<0.02），但在保留括约肌切除术患者中并非如此（P=0.2）。对所有相关因素（Dukes分期、组织学分级、年龄、性别、部位、择期或急诊手术）进行分层对数线性分析显示，Dukes分期和输血对复发的发生影响最为显著（χ2=54.04，自由度=6，P<0.0001；χ2=13.93，自由度=3，P<0.003）。结直肠癌根治性手术后的复发风险因手术当天输血而显著增加。
