Klimberg I, Sirois R, Wajsman Z, Baker J
Arch Surg. 1986 Nov;121(11):1326-9. doi: 10.1001/archsurg.121.11.1326.
The value of autotransfusion is widely recognized in the surgical community and may be of increasing importance in prevention of acquired immunodeficiency syndrome and hepatitis. The concern of potential contamination of the blood with viable tumor cells has resulted in limited use of autotransfusion in cancer surgery. The objective of this study was to examine the benefits and safety of autotransfusion in patients undergoing major surgery of genitourinary tumors. Autotransfusion was used in 49 consecutive patients. Twenty-four patients had radical cystectomy, ten had radical prostatectomy, 13 had radical nephrectomy, and two had other types of operations. An autotransfusion machine (Haemonetics Cell Saver) was used. The follow-up included physical examination, chest roentgenogram every three months, and bone scan and computed tomographic scan if clinically indicated. Liver and renal profiles were routinely performed every three months. Five of 49 patients developed metastases during follow-up examination from 12 to 23 months. The low incidence of metastatic spread and the pattern of spread fall to implicate autotransfusion as a cause of tumor dissemination. Autotransfusion and predeposited blood banking may result in elimination of or significant reduction in homologous transfusions.
自体输血的价值在外科领域已得到广泛认可，并且在预防获得性免疫缺陷综合征和肝炎方面可能愈发重要。由于担心血液被存活的肿瘤细胞污染，自体输血在癌症手术中的应用受到限制。本研究的目的是探讨自体输血在接受泌尿生殖系统肿瘤大手术患者中的益处和安全性。连续49例患者使用了自体输血。24例患者行根治性膀胱切除术，10例患者行根治性前列腺切除术，13例患者行根治性肾切除术，2例患者行其他类型手术。使用了一台自体输血机（血液回收机）。随访包括体格检查、每三个月进行一次胸部X线检查，以及根据临床指征进行骨扫描和计算机断层扫描。每三个月常规进行肝功能和肾功能检查。49例患者中有5例在12至23个月的随访检查期间发生转移。转移扩散的低发生率和扩散模式并不表明自体输血是肿瘤播散的原因。自体输血和预存式自体输血可能会减少或显著减少异体输血。
