Connor J P, Morris P C, Alagoz T, Anderson B, Bottles K, Buller R E
Department of Obstetrics and Gynecology, University of Iowa Hospitals and Clinics, Iowa City, USA.
Obstet Gynecol. 1995 Sep;86(3):373-8. doi: 10.1016/0029-7844(95)00183-R.
To evaluate intraoperative autologous blood collection with autotransfusion (Cell Saver) with respect to patient acceptance, risk of tumor cell co-transfusion, and risk of recurrence in patients undergoing radical hysterectomy for cervical cancer.
All patients explored for radical hysterectomy between August 1991 and July 1994 were offered the use of intraoperative autotransfusion. Clinical-pathologic and transfusion-related characteristics were compared for a group of historic controls surgically treated for similar disease. The risk of tumor cell co-transfusion was assessed intraoperatively with peritoneal cytology before blood collection, and postoperatively with Cell Saver blood cytology.
Ninety-eight patients were offered enrollment; four declined Cell Saver use, and 71 were acceptable for analysis. Thirty-one women (mean estimated blood loss 1338 mL) were reinfused with their own blood collected in the Cell Saver, whereas 40 patients (mean estimated blood loss 631 mL) were not autotransfused. There was no significant difference in preoperative hemoglobin concentration between groups. Cell Saver use significantly reduced the need for homologous transfusions, intraoperatively (P < .001) and postoperatively (P = .02). Historic controls (mean operative blood loss 1743 mL) were nearly four times more likely to have been transfused and three times more likely to have been transfused postoperatively than was the auto-transfused Cell Saver group. The mean hemoglobin concentration at discharge was lower in the autotransfused group, 9.3 g/dL, than in the historic controls, 10.8 g/dL. Nontransfused Cell Saver blood and all peritoneal cytologies were negative for tumor cells. Three pelvic recurrences, but no disseminated disease, have been noted over a mean follow-up of 24 months: one in the autotransfused group and two in the group in which the collected blood was discarded.
Cell Saver use is well accepted by patients, decreases the need for homologous transfusions, and does not appear to co-transfuse tumor cells.
评估宫颈癌根治性子宫切除术中自体血采集及自体输血（血液回收机）在患者接受度、肿瘤细胞共输血风险及复发风险方面的情况。
1991年8月至1994年7月期间所有接受根治性子宫切除术探查的患者均被提供术中自体输血。将一组因类似疾病接受手术治疗的历史对照患者的临床病理及输血相关特征进行比较。术中在采血前通过腹腔细胞学评估肿瘤细胞共输血风险，术后通过血液回收机回收的血液细胞学评估。
98例患者被纳入研究；4例拒绝使用血液回收机，71例可用于分析。31例女性（平均估计失血量1338 mL）回输了通过血液回收机采集的自身血液，而40例患者（平均估计失血量631 mL）未进行自体输血。两组术前血红蛋白浓度无显著差异。使用血液回收机显著减少了术中（P <.001）及术后（P =.02）对异体输血的需求。历史对照患者（平均手术失血量1743 mL）接受输血的可能性几乎是自体输血血液回收机组的四倍，术后接受输血的可能性是其三倍。自体输血组出院时的平均血红蛋白浓度为9.3 g/dL，低于历史对照患者的10.8 g/dL。未输血的血液回收机回收血液及所有腹腔细胞学检查肿瘤细胞均为阴性。平均随访24个月期间发现3例盆腔复发，但无远处转移：自体输血组1例，回收血液被丢弃组2例。
患者对使用血液回收机接受度良好，减少了异体输血需求，且似乎不会共输血肿瘤细胞。
