여호와 증인 환자에서 산부인과적 무혈 수술의 임상적 고찰 = Obstetric and Gynecologic Bloodless Surgery in Jehovah`s Witnesses

다국어 초록 (Multilingual Abstract)

Objective : Jehovah's Witnesses are members of a religious denomination whose beliefs prohibit the use of blood or blood products. Plasma volume expanders and extracorporeal hemodilution of the patients's own blood are theologically acceptiable. And so we evaluated effectiveness of major operative procedures carried out on Jehovas's Witnesses patients without blood transfusions or blood products. Methods : We retrospectively studied 50 cases of Jehovas's Witnesses who underwent obstetric and gynecologic bloodless surgery from February 1995 to August 1999. No patients recieved any blood or blood products during hospitalizaion. Results : The age distribution of patients was between 9 years and 58 year, average 36.7±8.7 years old. The most common cases for bloodless surgery was Cesarean section. The recombinant human erythropoietin(EPO) was treated in 5 cases of Cesarean section, 2 cases of TAH and 2 cases of ovarian tumor perioperatively. EPO-treated 9 cases were increased postoperative mean Hb levels compared with preoperative mean Hb levels. Histology revealed 9 cases of adenomyosis, 8 cases of leiomyoma, 3 cases of germ cell tumor, 2 cases of ectopic pregnancy, 1 case of CIS, 1 case of Krukenberg tumor, 1 case of epithelial cell tumor, 1 case of hemorrhagic corpus tumor and 1 case of sexcord stromal tumor, total 27 cases. There was no operative death and postoperative morbidities were few. Conclusions : We concluded that if we preformed the surgeries with careful operative techniques and various blood conserving procedures we could do the bloodless surgery of Jehovah's Witnesses with relative safety. But the establishment of a well programmed special medical supports for the Jehovah's Witnesses community will be needed in future.