Résumé
Objective To evaluate the application and risk of hematogenous tumor dissemination of intraoperative autologous blood salvage on radical nephrectomy for renal carcinoma with inferior vena cava tumor thrombus.Methods Between July 1999 and October 2005,19 patients with renal cell carcinoma invading inferior vena cava were used by the intraoperative autologous blood salvage.Preoperative and postoperative clinical data were analyzed and compared.The blood sparing effect and follow-up were evaluated.Results The intraoperative autologous blood salvage of all cases was successful.The levels of HCT,Hb and RBC on the 1st and 7th postoperative day were significantly lower than preoperative day.Although the level of PLT decreased on the 1st postoperative day,it recovered on the 7th day.The markers of liver and renal function did not change during treat time.Packed red blood cells were collected during surgery with a mean value of 1 765 ml(300～6 000 ml) per patient.The average amount of allogenic transfusion per patient was 2 247ml(0～8000 ml).The perioperative mortality rate was 10.5%(2/19).The postoperative metastasis rate was 35.3%(6/17).No difference was found in the prognosis between two groups.Conclusion The intraoperative autologous blood salvage does not markedly change the clinic test data and not increase the recurrence and metastasis of renal cell carcinoma.