Abstract: Objective To investigate the effect of three blood conservation procedures on recurrence and survival in patients with hepatocellular carcinoma (HCC) after radical resection,which is helpful to select the most suitable blood conservation procedure for HCC. Methods Two hundred twenty-five patients with different blood-saving strategies, i.e., acute normovolemic hemodilution (ANH group), low central venous pressure (LCVP group), and acute normovolemic hemodilution combined with low central venous pressure (ANH+LCVP group) with HCC underwent radical resection were included from January 2007 to December 2012. Blood loss and allogeneic blood transfusion were recorded according to protools. Disease-free survival and survival were recorded through postoperative follow-up. Results Fourteen patients were excluded because of loss to follow-up and 211 patients were included in the study finally. The blood loss and allogernic blood transfusion volumes in the ANH group[(816±420), (174±256) ml] were significantly higher than those in the LCVP[(655±441), (102±203) ml] and ANH+LCVP groups[(597±362), (52±136) ml] (P<0.05), respectively. The allogernic blood transfusion rates in the ANH group(37.0%) were significantly higher than that in the ANH+LCVP group(15.1%)(P<0.05). In all patients, the 1-, 3-year disease-free survival rates and the median disease-free survival time, survival time were significantly lower in the ANH group(50.7%, 25.6% and 23.05 months, 33.75 months) than those in ANH+LCVP group (67.1%, 47.7% and 30.65 months, 41.18 months)(P<0.05), respectively. However, there was no significant difference in the parameters above between the LCVP group and the left two groups (P>0.05). In patients with clinicopathological stages(TNM) Ⅰ and Ⅱ, the 1-, 3-year disease-free survival rates, the 1-year survival rates and the median disease-free survival time, survival time were significantly lower in the ANH group(64.8%, 35.5%, 85.2% and 28.30 months, 38.56 months) than those in ANH+LCVP group(82.1%, 61.8%, 96.4% and 37.43 months, 47.30 months) (P<0.05), respectively. There was no significant difference in the parameters above between the LCVP group and the left two groups (P>0.05). In patients with non-allogeneic blood transfusion and TNM stage Ⅲ and Ⅳ, The 1-, 3-, 5-year overall disease-free survival rates, survival rates, disease-free survival times and survival times showed no significant difference among the three groups (P>0.05). Conclusions Compared with ANH, acute normovolemic hemodilution combined with low central venous pressure can reduce blood loss and allogeneic blood transfusion in liver cancer surgery and prefer a better prognosis in patients early HCC.
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