The role of perioperative blood transfusion on postoperative outcomes and overall survival in patients after laparoscopic radical cystectomy
The role of perioperative blood transfusion on postoperative outcomes and overall survival in patients after laparoscopic radical cystectomy
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DOI：
10.4103/0973-1482.146125
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发表时间：
2016-01-01
影响因子：
1.3
通讯作者：
de la Pena Barthel, J. J.
中科院分区：
文献类型：
--
作者：
Gomez Rivas, Juan;Alonso y Gregorio, Sergio;de la Pena Barthel, J. J.
简介：过去几十年来，有不同的研究重点关注普外科患者以及围手术期输血 (PBT) 对癌症患者生存的影响，其中大多数研究支持 PBT 与实体瘤恶性肿瘤患者较差的生存率之间存在独立关联。本研究的目的是评估围手术期输血对 LRC 术后患者术后结局和生存的影响。 材料和方法：我们进行了一项回顾性研究，分析了 2005 年至 2012 年接受 LRC 手术治疗的 218 例患者。采用单向方差分析检验。采用Kaplan-Meier法估计生存率，并与log-rank进行比较，并采用Cox回归模型评估PBT与结果的相关性。结果：LRC系列的PBT率为16%。患者年龄、合并症、病理分期与PBT率无关。 PBT 率与感染并发症的出现之间存在统计学上显着的关系。使用 Kaplan-Meier 方法估计的总体 3 年生存率在输血组中显着较差：非输血患者为 41.38%，而未输血患者为 63.57%。 PBT 并不是 LRC 后患者生存的显着独立预测因素。主要的独立因素是 TNM 分类。结论：包括我们在内的许多研究都报告肿瘤手术后接受 PBT 的患者生存率较低。感染并发症与 PBT 之间存在相关性。我们必须努力限制接受膀胱癌根治性膀胱切除术的患者使用血液制品。
Introduction: There are different studies in the last decades focused on general surgery patients and the impact of perioperative blood transfusion (PBT) in cancer patients' survival, and most of them have supported an independent association between PBT and worse survival in those with solid tumor malignancies. The aim of this study is to evaluate the impact of perioperative blood transfusion on the postoperative outcomes and survival of patients after LRC.Materials and Methods: We performed a retrospective study analyzing our series of 218 patients surgically treated with LRC form 2005 to 2012. One-way analysis of variance test was used. Survival was estimated using the Kaplan - Meier method and was compared with log - rank and the Cox regression model was used to evaluate the association of PBT with the outcomes.Results: The PBT rate of LRC series was 16%. Patients' age, comorbidities and pathological stage were not related to the PBT rate. A statistically significant relationship was found between the PBT rate and the appearance of infectious complications. Overall 3 years survival estimated with the Kaplan-Meier method was significantly worse in the transfused group: 41.38% versus 63.57% for non-transfused patients. PBT was not a significant independent predictor factor in the survival of patients after LRC. The main independent factor was the TNM classification.Conclusions: Many studies including ours have reported a lower survival rate in patients who receive PBT after oncological surgery. There was a relationship between infectious complications and PBT. We have to make efforts to limit the use of blood products in patients surgically treated with radical cystectomy for bladder cancer.