Division of Otolaryngology, University of British Columbia, St, Paul's Sinus Centre, 1081 Burrard Street, Vancouver BC V6Z 1Y6, Canada.
J Otolaryngol Head Neck Surg. 2013 Jul 16;42(1):44. doi: 10.1186/1916-0216-42-44.
Endoscopic resection of sinonasal Inverted Papilloma (SNIP) tumors has been shown to reduce intra-operative blood loss and recovery time compared to open approaches. The purpose of this study is to investigate the incidence and requirements of blood transfusion for endoscopic SNIP surgeries.
An individual retrospective cohort study of endoscopic SNIP surgeries over a 10-year period was performed. Age, sex, pre-existing co-morbidity, use of anti-coagulants, tumor type and stage, time of surgery, estimated blood loss and the requirement for blood transfusion were recorded.
82 patients were included (57 males, 25 females). 4 (5%) Stage 1, 7 (8.5%) Stage 2, 62 (75.5%) Stage 3 and 9 (11%) Stage 4 SNIP tumors were identified according to the Krouse staging system. 3 (4%) patients required blood transfusion. 3 of the 9 (33%) Stage 4 tumors required blood transfusion. Stage 4 tumors were significantly associated with blood transfusion (p < 0.05). Higher staged tumors were associated with greater blood loss (p < 0.05) than lower staged cases. No other tumor stage required blood transfusion and no other pre-operative variable was associated with requirement for blood transfusion.
Endoscopic SNIP resections rarely require blood transfusions. No pre-operative factor other than tumor stage is associated with the requirement for blood transfusion. We would therefore suggest that only Stage 4 SNIP tumors require pre-operative type and screen.
与开放式手术相比，经鼻内镜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。本研究旨在探讨经鼻内镜 SNIP 手术中输血的发生率和需求。
对 10 年来经鼻内镜 SNIP 手术进行了个体回顾性队列研究。记录年龄、性别、既往合并症、抗凝药物使用、肿瘤类型和分期、手术时间、估计出血量和输血需求。
共纳入 82 例患者（男 57 例，女 25 例）。根据 Krouse 分期系统，发现 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 期肿瘤中 3 例需要输血。4 期肿瘤与输血显著相关（p<0.05）。高分期肿瘤的出血量明显多于低分期病例（p<0.05）。其他肿瘤分期均无需输血，其他术前变量与输血需求无关。
经鼻内镜 SNIP 切除术很少需要输血。除肿瘤分期外，无其他术前因素与输血需求相关。因此，我们建议仅对 4 期 SNIP 肿瘤进行术前血型和筛查。
