Die Bedeutung der Bluttransfusion in der kolorektalen Tumorchirurgie

K. Pfister; B. Dietl; A. Fürst; G. Multhoff; K.-W. Jauch

doi:10.1055/s-2002-32389

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Viszeralchirurgie 2002; 37(3): 250-258
DOI: 10.1055/s-2002-32389

Originalarbeit

Die Bedeutung der Bluttransfusion in
der kolorektalen Tumorchirurgie

Significance of blood transfusion in colorectal cancerK. Pfister¹ , B. Dietl² , A. Fürst¹ , G. Multhoff³ , K.-W. Jauch¹

¹Chirurgische Klinik und Poliklinik der Universität Regensburg
²Strahlentherapie der Universität Regensburg
³Hämatologie und internistische Onkologie der Universität Regensburg, AG Natürliche Killerzellen

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Publication History

Publication Date:
20 June 2002 (online)

Abstract
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Zusammenfassung

Mehr als die Hälfte aller Patienten mit kolorektalem Karzinom wird durch die tumorinduzierte Anämie und den perioperativen Blutverlust transfusionsbedürftig. Obwohl bisher der kausale Mechanismus nicht bekannt ist, gilt die fremdblutassoziierte Immunsuppression experimentell und klinisch als bewiesen. Eine Erhöhung der postoperativen Infektionsrate durch die Transfusion wird übereinstimmend bejaht, die Beeinträchtigung der Tumorprognose sowie eine erhöhte Rezidivrate jedoch kontrovers diskutiert. In dieser Übersichtsarbeit wurde die Literatur zum gesamten Themenkomplex zusammengetragen und analysiert. Die überwiegend retrospektiven Daten lassen derzeit keine definitive Beurteilung der klinischen Auswirkungen des negativen Transfusionseffektes zu. Dennoch sollte der Risikofaktor Bluttransfusion möglichst vermieden werden.

Abstract

More than half of all patients with colorectal cancer need blood transfusion because of tumor induced anemia or perioperative blood loss. Transfusion associated immunosuppression is a well known phenomenon although underlying mechanism is still not understood. Whereas in most studies concerning postoperative infection rate allogeneic blood transfusion had been an independent risk factor, controversial data have been published regarding the influence on colorectal cancer prognosis and tumor recurrence. The review analyzed the literature currently available. Clinical consequences of mainly retrospective surveys remain unclear. Therefore we suggest to avoid homologous blood transfusion wherever possible.

Schlüsselwörter

Anämie - Bluttransfusion - kolorektales Karzinom - postoperative Infektionsrate - Tumorprognose

Key words

Tumor induced anemia - Blood transfusion - Colorectal cancer - Postoperative infection rate - Cancer prognosis

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Dr. K. Pfister

Chirurgische Klinik und Poliklinik der Universität Regensburg

Franz-Josef-Strauß-Allee 11

93053 Regensburg

Phone: 0941-9446801

Fax: 0941-9446802

Email: Karin.pfister@Klinik.uni-regensburg.de