Retrospective analysis of the efficacy of perioperative use of the cell salvage and autologous blood recovery system during laparoscopic myomectomy.
OBJECTIVE
To evaluate the benefit of the intraoperative use of a cell salvage and autologous blood recovery system during laparoscopic myomectomy (LM).


METHODS
We retrospectively reviewed the medical records of 538 patients who underwent LM between January 2008 and December 2009 at our hospital. Patients undergoing LM were divided into two groups depending on whether the cell salvage and autologous blood recovery system was used; the use of the system was at the discretion of the surgeon. The system for intraoperative hemorrhage was employed based on the surgeon's decision.


RESULTS
Of the 583 patients, 23 patients (4.3%) underwent LM using the system. No patient required an allogeneic blood transfusion during or after the surgery. The median surgical time (183 vs. 100 m), total blood loss (520 vs. 100 mL), total weight of enucleated myomas (390 vs. 175 g), and postoperative calculated δ-Hemoglobin (δ-Hb) (2 vs. 1.6 g/dL) were significantly increased in the 23 patients in whom the system was used. The median autologous blood volume recovered by intraoperative use of the system and transferred to the 23 patients was 250 mL (range 125-800 mL). For patients in whom the system was not used, the total blood loss significantly correlated to δ-Hb (r = 0.29; P < 0.01). However, there was no such correlation in patients in whom the system was not used (r = 0.04; P = 0.86).


CONCLUSIONS
The adoption of a cell salvage and autologous blood recovery system during LM was useful for patients with severe hemorrhage.
Department of Obstetrics and Gynecology, Juntendo University School of Medicine, Hongo 2-1-1, Bunkyo-ku, Tokyo 113-8421, Japan. kumakiri@juntendo.ac.jp
Jun
J
Kumakiri
Iwaho
I
Kikuchi
Mari
M
Kitade
Shozo
S
Matsuoka
Ayako
A
Kono
Satoru
S
Takeda
D000328:Adult; D016063:Blood Loss, Surgical; D001804:Blood Transfusion, Autologous; D002983:Clinical Competence; D003657:Decision Making; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery*; D057725:Operative Blood Salvage; D019990:Perioperative Care; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000601:surgery*