Preoperative isovolemic hemodilution in patients with radical hysterectomy for cervical cancer: experience of 12 cases at the Hospital Dr. Rafael Ángel Calderón Guardia
DOI:
https://doi.org/10.51481/amc.v44i4.432Keywords:
Anemia, hemodilución, sangrado, cáncer, complicaciones, transfusión alogénicaAbstract
Justification:Cervical cancer is the most frequent neoplasicpathology among the feminine population. In cases of local-ized invasion, radical hysterectomy should be considered acurative treatment. However a significative transoperativebleeding makes a transfusion necessary in many cases, withall the complications that this endures. As far as we knowthere is not a published study about the isovolemic hemodi-lution technique to reduce the transfusional requirements inthese patients in the national literature.Objective:Demonstrate that the isovolemic hemodilutionreduces the necessity of allogeneic blood transfusion inpatients who have undergone radical hysterectomy.
Materials and methods:The study was prospective. All ofthe chosen patients, were selected in consecutive order andthey received radical hysterectomy due to cervical cancer instage I-B1 (n=10), the rest of the patients were in stage I-B2(n-1) and I-A2 (n=1). Attaining an average of 1208 ml ofautologous blood per patient. The procedure was well toler-ated, except one case where the patient presented hemody-namic compromise attributable to the blood withdrawing.Comparing the basal values with the ones obtained beforeretransfusion, we observed an average decrease of thehemoglobin, hematocrit and platelets of 4.2 g/dl, 14.4% and52.000/μl respectively. None of the patients required allo-geneic blood transfusion.
Conclusions:The preoperative isovolemic hemodilution isan easy and effective technique to reduce the necessity ofallogeneic blood transfusion in patients who have undergoneradical hysterectomy due to cervical cancer. It‘ s related witha low incidence of complications, but is recommended aclose vigilance of the transoperative hemodynamic state,especially during the time of the blood withdrawing.
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