Zur Aufklärungspflicht und Häufigkeit homologer Bluttransfusionen bei einzeitigen Mammakarzinom-Operationen

Abstract

According to a judgement by the German Federal Court of 17 December 1991 the surgeon is legally bound to inform the patient before hand of the risk of a possible homologous blood transfusion during surgery. If the transfusion probability exceeds 5%, this obligation is really relevant, 228 patients with primary breast cancer of stage pT1 - 3N0 - 2M0 had been treated either radically (n = 146) or by a breast-preserving operation (n = 82) from January 1989 to December 1993. 400 to 800 ml erythrocyte preparations had been placed at disposal in advance for each patient. The rate of blood transfusions, pre- and postoperative haemoglobin (Hb), age, tumour size, lymph node involvement, kind and duration of operation as well as postoperative course have been analysed 43 of 228 (18.9%) patients received a homologous blood transfusion within 24 hours after operation. Transfusion rate per year decreased from 39.4% (1989) to 44.8% (1990), 12.2% (1991), 16.6% (1992) and 3.1% in 1993. On the contrary mean pre-and postoperative haemoglobin levels did not differ significantly (p < 0.05) between the different years: 13.4 +/- 0.8 respectively 12.1 +/- 1.1 g/dl (1989) and 13.5 +/- 1.3 respectively 12.1 +/- 1.3 g/dl (1993). Patients who had transfusions were significantly (p < 0.05) more likely to suffer from preoperative anaemia and larger tumors, and they have been treated by mastectomy more frequently compared to patients without transfusion. There were no correlations between transfusions and age, tumour size, lymph node involvement, kind and duration of operation.(ABSTRACT TRUNCATED AT 250 WORDS)