The long-term outcomes of patients with hepatocellular carcinoma after intraoperative autotransfusion : a systematic review and meta-analysis of cohort studies
The long-term outcomes of patients with hepatocellular carcinoma after intraoperative autotransfusion : a systematic review and meta-analysis of cohort studies
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发表时间：
2018
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通讯作者：
T. Guo;Ling Jiang;Bin Luo;Yuanshuai Huang
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作者：
T. Guo;Ling Jiang;Bin Luo;Yuanshuai Huang
在癌症手术中是否可以使用自体输血仍然存在争议。我们的目的是评估术中自体输血对肝细胞癌（HCC）患者的长期影响。检索Pubmed、Embase和Cochrane图书馆数据库，比较HCC患者术中自体输血与异体输血的队列。比较肿瘤复发率、3年无复发生存率和3年死亡率3个结局指标。共纳入8项队列研究的1175例患者，分为自身输血组（AT组）和非自身输血组（non-AT组）。两组无复发生存率差异无统计学意义（RR=1.18, 95% CI 1.03 ~ 1.36, I2=43.8%）。但AT组在肿瘤复发和死亡方面有轻微优势（肿瘤复发的RR =0.85, 95% CI 0.71 ~ 1.02, I2=0.0%；死亡率的HR =0.80, 95% CI 0.58 ~ 1.11, I2=0.0%）。因此，我们的分析表明，术中自体输血不会增加HCC患者的癌症复发和死亡风险，证明了自体输血在肝癌手术中的安全性。
There still exits the controversy whether autotransfusion could be used during the cancer surgery. Our aim is to evaluate the long-term effects of intraoperative autotransfusion on patients with hepatocellular carcinoma (HCC). Pubmed, Embase and the Cochrane Library databases were searched for cohorts comparing intraoperative autotransfusion with allogeneic transfusion in patients with HCC. Three outcome indicators including cancer recurrence, the three-year recurrence free survival and three-year mortality were compared. A total of 1175 patients from eight cohort studies were included and separated into autotransfusion group (AT group) and non-autotransfusion group (non-AT group). There wasn’t a significant difference in recurrence free survival (RR=1.18, 95% CI 1.03-1.36, I2=43.8%) between two groups. But a slight preponderance were observed in AT group when evaluating the cancer recurrence and the death (RR of the cancer recurrence=0.85, 95% CI 0.71-1.02, I2=0.0%; HR of mortality =0.80, 95% CI 0.58-1.11, I2=0.0%). So, our analysis showed that intraoperative autotransfusion will not increase the risk of cancer recurrence and mortality on patients with HCC, and proved the safety of autotransfusion in liver cancer surgery.