Naresh Kumar1, Qasim Ahmed2, Victor K M Lee2, Aye Sandar Zaw3, Raymond Goy4, Hee Kit Wong3. 1. Department of Orthopaedic Surgery, National University Health System, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228, Singapore. dosksn@nus.edu.sg. 2. Department of Pathology, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore. 3. Department of Orthopaedic Surgery, National University Health System, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228, Singapore. 4. Department of Anaesthesia, National University Hospital, 5 Lower Kent Ridge Road, Singapore, 119074, Singapore.
Abstract
PURPOSE: To evaluate the feasibility of using intraoperative cell salvage (IOCS) in combination with leucocyte depletion filter (LDF) in eliminating tumour cells from blood salvaged during metastatic spine tumour surgery (MSTS). This is with the view to pave the path for use of IOCS-LDF in MSTS and musculoskeletal oncological surgery. METHODS: Sixty consecutive patients with known primary epithelial tumour, who were offered surgery for metastatic spine disease at our university hospital, were recruited. Blood samples were collected at three different stages during surgery: from operative field prior to IOCS processing, after IOCS processing and after IOCS-LDF processing. Three separate samples (5 ml each) were taken at each stage. Samples were examined by cell block technique using immunohistochemical monoclonal antibodies to identify tumour cells of epithelial origin in the samples. RESULTS: Of 60 patients, ten were excluded for not fulfilling the inclusion criteria leaving 50 patients. Malignant tumour cells were detected in the samples from operative field prior to IOCS processing in 24 patients and in the samples from the transfusion bag post-IOCS processing in 4 patients. No viable malignant cells were detectable in any of the blood samples after passage through both IOCS and LDF. CONCLUSIONS: The findings support the notion that IOCS-LDF combination works effectively in eliminating tumour cells from salvaged blood so this technique can possibly be applied in MSTS and even musculoskeletal oncological surgery. This concept can then be extended to other oncological surgeries in general with further appropriate clinical studies.
PURPOSE: To evaluate the feasibility of using intraoperative cell salvage (IOCS) in combination with leucocyte depletion filter (LDF) in eliminating tumour cells from blood salvaged during metastatic spine tumour surgery (MSTS). This is with the view to pave the path for use of IOCS-LDF in MSTS and musculoskeletal oncological surgery. METHODS: Sixty consecutive patients with known primary epithelial tumour, who were offered surgery for metastatic spine disease at our university hospital, were recruited. Blood samples were collected at three different stages during surgery: from operative field prior to IOCS processing, after IOCS processing and after IOCS-LDF processing. Three separate samples (5 ml each) were taken at each stage. Samples were examined by cell block technique using immunohistochemical monoclonal antibodies to identify tumour cells of epithelial origin in the samples. RESULTS: Of 60 patients, ten were excluded for not fulfilling the inclusion criteria leaving 50 patients. Malignant tumour cells were detected in the samples from operative field prior to IOCS processing in 24 patients and in the samples from the transfusion bag post-IOCS processing in 4 patients. No viable malignant cells were detectable in any of the blood samples after passage through both IOCS and LDF. CONCLUSIONS: The findings support the notion that IOCS-LDF combination works effectively in eliminating tumour cells from salvaged blood so this technique can possibly be applied in MSTS and even musculoskeletal oncological surgery. This concept can then be extended to other oncological surgeries in general with further appropriate clinical studies.
Authors: Thomas Frietsch; Andrea U Steinbicker; Audrey Horn; Matthes Metz; Gerald Dietrich; Markus A Weigand; Jonathan H Waters; Dania Fischer Journal: Transfus Med Hemother Date: 2022-05-11 Impact factor: 4.040
Authors: Virginia J Aijtink; Vera C Rutten; Beatrice E M Meijer; Renate de Jong; John L Isaac; Wojciech G Polak; M Thamara P R Perera; Dimitri Sneiders; Hermien Hartog Journal: Ann Surg Date: 2022-07-06 Impact factor: 13.787
Authors: Raphaële Charest-Morin; Charles G Fisher; Ann L Versteeg; Arjun Sahgal; Peter Pal Varga; Daniel M Sciubba; James M Schuster; Michael H Weber; Michelle J Clarke; Laurence D Rhines; Stefano Boriani; Chetan Bettegowda; Michael G Fehlings; Paul M Arnold; Ziya L Gokaslan; Nicolas Dea Journal: Ann Transl Med Date: 2019-05