Division of Otolaryngology, University of British Columbia, St. Paul’s Sinus Centre, Vancouver, BC.
J Otolaryngol Head Neck Surg. 2012 Dec;41(6):413-8.
Endoscopic resection of sinonasal inverted papilloma (SNIP) tumours has been shown to reduce intraoperative blood loss and recovery time compared to open approaches.
The purpose of this study was to investigate the incidence and requirements of blood transfusion for endoscopic SNIP surgeries.
Individual retrospective cohort study.
St. Paul's Sinus Centre, a tertiary referral rhinology centre.
An individual retrospective cohort study of endoscopic SNIP surgeries over a 10-year period was performed. Age, sex, pre-existing comorbidity, use of anticoagulants, tumour type and stage, time of surgery, estimated blood loss, and requirement for blood transfusion were recorded.
Incidence of blood transfusion, type and screen, and crossmatch requisitions.
Eighty-two patients were included (57 males, 25 females). Four (5%) stage 1, 7 (8.5%) stage 2, 62 (75.5%) stage 3, and 9 (11%) stage 4 SNIP tumours were identified according to the Krouse staging system. Three (4%) patients required blood transfusion. Three of the nine (33%) stage 4 tumours required blood transfusion. Stage 4 tumours were significantly associated with blood transfusion (p < .05). Higher-staged tumours were associated with greater blood loss (p < .05) than lower-staged cases. No other tumour stage required blood transfusion, and no other preoperative variable was associated with the requirement for blood transfusion.
Endoscopic SNIP resections rarely require blood transfusions. No preoperative factor other than tumour stage is associated with the requirement for blood transfusion. We therefore suggest that only stage 4 SNIP tumours require preoperative type and screen testing.
与开放式手术相比，内镜下鼻腔鼻窦内翻性乳头状瘤（SNIP）切除术可减少术中失血量和恢复时间。
本研究旨在调查内镜 SNIP 手术中输血的发生率和需求。
个体回顾性队列研究。
圣保罗鼻窦中心，一个三级转诊鼻科中心。
对 10 年内进行的内镜 SNIP 手术进行了个体回顾性队列研究。记录了年龄、性别、既往合并症、抗凝药物使用、肿瘤类型和分期、手术时间、估计失血量以及输血需求。
输血的发生率、血型和筛查以及交叉配血的需求。
共纳入 82 例患者（57 例男性，25 例女性）。根据 Krouse 分期系统，4 例（5%）为 1 期、7 例（8.5%）为 2 期、62 例（75.5%）为 3 期和 9 例（11%）为 4 期 SNIP 肿瘤。3 例（4%）患者需要输血。9 例（33%）4 期肿瘤需要输血。4 期肿瘤与输血显著相关（p <.05）。与低分期病例相比，高分期肿瘤与更多的失血相关（p <.05）。没有其他肿瘤分期需要输血，也没有其他术前变量与输血需求相关。
内镜 SNIP 切除术很少需要输血。除肿瘤分期外，没有其他术前因素与输血需求相关。因此，我们建议只有 4 期 SNIP 肿瘤需要术前血型和筛查检测。
