TAILIEUCHUNG - Non-blood medical care in gynecologic oncology: a review and update of blood conservation management schemes

Consider an HIV-positive pregnant woman who lives in drought-stricken rural Africa. She has walked several miles with a child on her back to reach the nearest health facility. Here, her child will receive some basic primary care and be vaccinated against measles and other vaccine-preventable diseases. This facility is small and provides only limited services; consequently, the woman will be unable to receive basic obstetric care here when she is ready to deliver her next child. For basic obstetric care, she must travel to a different clinic in another village. Reaching that clinic will be a challenge because there is. | Simou et al. World Journal of Surgical Oncology 2011 9 142 http content 9 1 142 5 2 WORLD JOURNAL OF SURGICAL ONCOLOGY REVIEW Open Access Non-blood medical care in gynecologic oncology a review and update of blood conservation management schemes 1 1 -2 1 1 1 Maria Simou Nikolaos Thomakos Flora Zagouri Antonios Vlysmas Nikolaos Akrivos Dimitrios Zacharakis Christos A Papadimitriou 2 Meletios-Athanassios Dimopoulos2 Alexandras Rodolakis1 and Aris Antsaklis1 Abstract This review attempts to outline the alternative measures and interventions used in bloodless surgery in the field of gynecologic oncology and demonstrate their effectiveness. Nowadays as increasingly more patients are expressing their fears concerning the potential risks accompanying allogenic transfusion of blood products putting the theory of bloodless surgery into practice seems to gaining greater acceptance. An increasing number of institutions appear to be successfully adopting approaches that minimize blood usage for all patients treated for gynecologic malignancies. Preoperative intraoperative and postoperative measures are required such as optimization of red blood cell mass adequate preoperative plan and invasive hemostatic procedures assisting anesthetic techniques individualization of anemia tolerance autologous blood donation normovolemic hemodilution intraoperative cell salvage and pharmacologic agents for controlling blood loss. An individualised management plan of experienced personnel adopting a multidisciplinary team approach should be available to establish non-blood management strategies and not only on demand of the patient in the field of gynecologic oncology with the use of drugs devices and surgical-medical techniques. Keywords bloodless surgery gynecologic oncology blood salvage hemodilution Review With the advent of technology and advanced procedures in the field of medicine an emerging issue of restricting allogenic blood transfusion has arisen. The medical knowledge

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