Utilization and cost of cell salvage in minimally invasive myomectomy.

Autor: Wu H; Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Singh B; Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America. Electronic address: bsingh10@jhmi.edu., Yen TT; Division of Gynecologic Oncology, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Maher J; Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Datta S; Division of Reproductive Sciences and Women's Health Research, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Chaves K; Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Lau BD; Division of Health Sciences Informatics, Johns Hopkins University School of Medicine, Baltimore MD, United States of America., Frank S; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Simpson K; Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Patzkowsky K; Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Wang K; Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Jazyk: angličtina
Zdroj: European journal of obstetrics, gynecology, and reproductive biology [Eur J Obstet Gynecol Reprod Biol] 2023 Jan; Vol. 280, pp. 179-183. Date of Electronic Publication: 2022 Dec 09.
DOI: 10.1016/j.ejogrb.2022.12.014
Abstrakt: Objective: To assess the utilization and cost of intraoperative cell salvage (ICS) in minimally invasive myomectomy.
Study Design: Retrospective cohort study of patients who underwent minimally invasive myomectomy at a quaternary care academic hospital. Patients were classified into: ICS setup vs no ICS setup, ICS setup with reinfusion vs ICS setup without reinfusion.
Results: Of 382 patients who underwent minimally invasive myomectomy, 67 (17.5 %) had ICS setup, 30 (44.8 %) of those patients reinfused. Median volume of reinfusion per patient was 300 mL (range 125-1000 mL). Patients who ultimately underwent ICS reinfusion, compared to those with ICS setup only, had significantly larger mean maximum fibroid size (9.8 cm vs 8.0 cm, p = 0.02), higher median total specimen weight (367 vs 304 g, p = 0.03), higher median estimated blood loss (575 vs 300 mL, p < 0.0001), longer mean operative time (261 vs 215 min, p = 0.04). No perioperative complications were associated with ICS. Higher costs are associated with universal use or complete lack of ICS; lowest cost is associated with ICS setup only for those ultimately reinfused.
Conclusion: ICS might reduce requirements for allogeneic blood transfusions in patients undergoing minimally invasive myomectomy, and may contribute to cost savings. Uterine and maximum fibroid sizes are possible preoperative indicators for patients who require cell salvage reinfusion.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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