Document Detail


Blood salvage and cancer surgery: a meta-analysis of available studies.
MedLine Citation:
PMID:  22321196     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intraoperative blood salvage (IBS) is a technique that is frequently used in major blood loss surgery. Classically, it is avoided during cancer surgery where a fear exists of entraining cancer cells into the shed blood. In this study, all reports of this practice were collected to determine if this fear is warranted.
STUDY DESIGN AND METHODS: A literature search was performed including the search phrases "blood salvage,""intraoperative blood salvage,""cell salvage,""cell saver,""cell saving,""autotransfusion," and "autologous transfusion." Data extracted from suitable papers included the authors' names, publication year, cancer type, exclusion criteria, sample size, length of follow-up, and the mean patient age. The primary endpoint of this meta-analysis was a comparison of the odds ratio (OR) for cancer recurrence or the development of metastases.
RESULTS: Eleven studies were included in the analysis. The pooled summary of the OR was 0.65 (95% confidence interval, 0.43-0.98; p = 0.0391) using a random-effects model. Measures of heterogeneity, Q-statistics (p= 0.1615) and I(2) (30.90%), did not indicate a high degree of between-study variability.
CONCLUSIONS: While significant variability existed between studies, this meta-analysis suggests that outcomes after the use of IBS are not inferior to traditional intraoperative allogeneic transfusion. An adequately powered prospective, randomized trial of IBS use is required to determine its true risk during cancer surgery.
Authors:
Jonathan H Waters; Mark Yazer; Yi-Fan Chen; John Kloke
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Publication Detail:
Type:  Comparative Study; Journal Article; Meta-Analysis; Research Support, N.I.H., Extramural     Date:  2012-02-10
Journal Detail:
Title:  Transfusion     Volume:  52     ISSN:  1537-2995     ISO Abbreviation:  Transfusion     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-31     Completed Date:  2013-01-14     Revised Date:  2013-01-28    
Medline Journal Info:
Nlm Unique ID:  0417360     Medline TA:  Transfusion     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2167-73     Citation Subset:  IM    
Copyright Information:
© 2012 American Association of Blood Banks.
Affiliation:
Department of Anesthesiology, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, USA.
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MeSH Terms
Descriptor/Qualifier:
Blood Transfusion
Blood Transfusion, Autologous / adverse effects
Female
Humans
Male
Neoplasm Metastasis / prevention & control*
Neoplasm Recurrence, Local
Neoplasms / blood,  surgery*
Neoplastic Cells, Circulating*
Odds Ratio
Operative Blood Salvage / adverse effects*,  contraindications
Risk
Treatment Outcome
Grant Support
ID/Acronym/Agency:
UL1 RR024153-04S4/RR/NCRR NIH HHS
Comments/Corrections
Comment In:
Transfusion. 2012 Dec;52(12):2723-4; author reply 2724   [PMID:  23231674 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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