PERIOPERATIVE BLOOD TRANSFUSION IN SURGERY FOR ESOPHAGEAL CANCER-EXPERIENCE IN A COUNTRY HOSPITAL

• Kunori Takao

  Department of Surgery and Blood Transfusion Unit, Iwaki-kyoritsu Hospital

• Yamauchi Ikuko

  Central Laboratory, Iwaki-kyoritsu Hospital

• Nishiyama Chiharu

  Central Laboratory, Iwaki-kyoritsu Hospital

• Suzuki Kuniko

  Central Laboratory, Iwaki-kyoritsu Hospital

• Wakamatsu Kazuyo

  Central Laboratory, Iwaki-kyoritsu Hospital

• Kanno Eiko

  Central Laboratory, Iwaki-kyoritsu Hospital

Bibliographic Information

Other Title

• 食道癌外科手術における周術期輸血―地方病院での現状と問題点

Abstract

We analyzed perioperative packed red cell blood transfusion (RBC-TF) in surgery for esophageal carcinoma to improve the usage of blood products.<br>Methods: From 1993 to 2002, 52 patients (mean, 63.5 years) underwent esophagectomy for esophageal cancer. By stage, there were 13 cases of stage 0 disease (25%), 11 stage 1 (21%), 12 stage 2 (23%), 9 stage 3 (17%) and 7 stage 4 (14%).<br>Results: Irradiated red cell products (Ir-RBC) were used in 12 patients (22%) for intraoperative bleeding (mean 1,187 ml), whereas no RBC-TF was performed in 40 patients (609 ml; p<0.001). Operation time did not differ statistically between the two groups (452 min vs 426 min). RBC-TF was often performed intraoperatively in patients with episodes of low blood pressure (<80 mmHg) during anesthesia, although their blood loss was less than 500 ml. Fresh frozen plasma (FFP) was used in parallel with RBC-TF during surgery, whereas plasma protein fraction (PPF) was used in no relation to blood loss. RBC-TF was performed postoperatively in 17 of 40 patients (43%) with no intraoperative RBC-TF and in 11 of 12 patients (92%) with intraoperative RBC-TF. Multivariate analysis revealed that blood loss and water imbalance in body fluid were independently correlated with postoperative RBC-TF. Serum sodium (Na) level in body fluid decreased from 142 mEq/l (mean) to 135 mEq/l after surgery. Postoperative pneumonia and anastomotic leakage occurred in patients with RBC-TF at the ratio of 10% (p<0.198) and 28% (p<0.0009), respectively, whereas these complications did not occur in patients without periperative RBC-TF.<br>Conclusion: The use of RBC-TF often appeared excessive. Proper management of BTF therapy is necessary.

Journal

• Japanese Journal of Transfusion and Cell Therapy

  Japanese Journal of Transfusion and Cell Therapy 53 (1), 17-23, 2007

  The Japan Society of Transfusion Medicine and Cell Therapy

Keywords

• esophageal surgery
• perioperative blood transfusion
• appropriate use

Details

• CRID: 1390282680250229760
• NII Article ID: 10018733072
• NII Book ID: AA12159645
• DOI: 10.3925/jjtc.53.17
• ISSN: 18830625
• ISSN: 18813011
• Web Site: https://search.jamas.or.jp/link/ui/2007164138
• Text Lang: ja
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed