Abstract

SANCHEZ-SUEN, Kwok Ho; FUSTER-ALFARO, Francisco  and  CHAVES-VILLALOBOS, Jorge. Hemodilución isovolémica preoperatoria en pacientes con histerectomía radical por cáncer de cérvix: experiencia de 12 casos en el Hospital Dr. Rafael Ángel Calderón Guardia. Acta méd. costarric [online]. 2002, vol.44, n.4, pp.155-159. ISSN 0001-6002.

Justification: Cervical cancer is the most frequent neoplasic pathology among the feminine population. In cases of localized invasion, radical hysterectomy should be considered a curative treatment. However a significative transoperative bleeding makes a transfusion necessary in many cases, with all the complications that this endures. As far as we know there is not a published study about the isovolemic hemodilution technique to reduce the transfusional requirements in these patients in the national literature. Objective: Demonstrate that the isovolemic hemodilution reduces the necessity of allogeneic blood transfusion in patients who have undergone radical hysterectomy. Materials and methods: The study was prospective. All of the chosen patients, were selected in consecutive order and they received radical hysterectomy due to cervical cancer in stage 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 of autologous blood per patient. The procedure was well toler-ated, except one case where the patient presented hemodynamic compromise attributable to the blood withdrawing. Comparing the basal values with the ones obtained before retransfusion, we observed an average decrease of the hemoglobin, hematocrit and platelets of 4.2 g/dl, 14.4% and 52.000 μl respectively. None of the patients required allogeneic blood transfusion. Conclusions: The preoperative isovolemic hemodilution is an easy and effective technique to reduce the necessity of allogeneic blood transfusion in patients who have undergone radical hysterectomy due to cervical cancer. It‘s related with a low incidence of complications, but is recommended a lose vigilance of the transoperative hemodynamic state, especially during the time of the blood withdrawing.

Keywords : Anemia; hemodilución; sangrado; cáncer; complicaciones; transfusión alogénica.