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GUEST EDITORIAL
Year : 2010  |  Volume : 26  |  Issue : 2  |  Page : 158
 

Intra-operative cell salvage in radical cystectomy


Department of Urology, Surrey and Sussex NHS Trust, United Kingdom

Date of Web Publication12-Jul-2010

Correspondence Address:
Abhay Rane
Department of Urology, Surrey and Sussex NHS Trust
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-1591.65379

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How to cite this article:
Rane A. Intra-operative cell salvage in radical cystectomy. Indian J Urol 2010;26:158

How to cite this URL:
Rane A. Intra-operative cell salvage in radical cystectomy. Indian J Urol [serial online] 2010 [cited 2019 Jun 17];26:158. Available from: http://www.indianjurol.com/text.asp?2010/26/2/158/65379


Perioperative allogeneic blood transfusion is regularly utilized in major pelvic uro-oncological surgery, although the requirements have decreased over the past few years, primarily due to improved technical maneuvers and the availability and uptake of laparoscopic / robotic routes. However, wherever the risk is quantifiable, it makes sound medical sense to utilize the cell saver, with its lower risk of transfusion related reactions. The authors [1] have elegantly demonstrated a significant monetary advantage as well, with cell salvage, in 15 consecutive patients undergoing radical cystectomy.

In general, the trend appears to be one of opting for use of cell salvage wherever possible, primarily due to the shortage of easily available allogeneic blood, and the possibility of transfusion related reactions. One of the concerns raised by many oncologic surgeons relates to the theoretical risk of dissemination of cancer. However, studies by various authors indicate that the survival rate of patients who received cell salvaged blood did not significantly differ from the group of patients who did not receive cell salvaged blood. These studies have been referenced in the article.

A number of metanalyses [2] have confirmed that cell salvage may be a cost-effective method to reduce exposure to allogeneic blood transfusion in all fields of surgery. Cell salvage has lower costs and slightly higher quality-adjusted life years compared with all of the alternative transfusion strategies except for acute normovolaemic haemodilution, which has not been in routine practice for oncological surgery.

 
   References Top

1.Ubee SS, Manikandan R, Gudimetla AR, Singh G. Cost benefits of intraoperative cell salvage in radical cystectomy. Indian J Urol 2010;26:196-9.  Back to cited text no. 1    Medknow Journal  
2.Davies L, Brown TJ, Haynes S, Payne K, Elliott RA, McCollum C. Cost-effectiveness of cell salvage and alternative methods of minimising perioperative allogeneic blood transfusion: A systematic review and economic model. Health Technol Assess 2006;10:iii-iv,ix-x,1-210.  Back to cited text no. 2      




 

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