University College London Hospitals NHS Foundation Trust, UK.
Ann R Coll Surg Engl. 2021 Jun;103(6):412-414. doi: 10.1308/rcsann.2020.7135. Epub 2021 Apr 14.
Two group and save (G&S) samples are routinely collected from patients undergoing diagnostic laparoscopy and/or emergency appendicectomy. We aimed to identify the necessity of this practice by looking at the perioperative transfusion rates.
Data were obtained from our electronic theatre system for all patients who underwent emergency laparoscopic surgery (specifically diagnostic laparoscopy and/or laparoscopic appendicectomy) between January 2017 and December 2018. Records were reviewed for the number of G&S samples sent and perioperative transfusion rates.
A total of 451 patients were included in the study. The numbers of procedures performed in 2017 and 2018 were 202 (44.8%) and 249 (55.2%), respectively. The total number of samples sent was 930. Only 786 (84.5%) samples were processed and the rest were rejected for various reasons. Of the 451 patients included in the study, 308 (68.3%) had two G&S samples sent, whereas 41 patients (9.1%) had only one G&S sample sent. Fifty-six (12.4%) and 20 (4.4%) patients had three and four G&S samples sent, respectively. Only two patients required transfusion perioperatively (0.4%), and the indication in both was irrelevant to the primary operation.
These results demonstrate a near-zero transfusion rate in this patient cohort. Omitting G&S is safe and potentially saves time and resources.
在接受诊断性腹腔镜检查和/或急诊阑尾切除术的患者中,通常会采集两组和保存(G&S)样本。我们旨在通过观察围手术期输血率来确定这种做法的必要性。
从我们的电子手术室系统中获取了 2017 年 1 月至 2018 年 12 月期间所有接受紧急腹腔镜手术(具体为诊断性腹腔镜检查和/或腹腔镜阑尾切除术)的患者的数据。记录了发送的 G&S 样本数量和围手术期输血率。
共有 451 例患者纳入研究。2017 年和 2018 年分别进行了 202 例(44.8%)和 249 例(55.2%)手术。共发送了 930 个样本。只有 786 个(84.5%)样本被处理,其余样本因各种原因被拒绝。在纳入研究的 451 例患者中,有 308 例(68.3%)患者发送了两份 G&S 样本,而有 41 例(9.1%)患者仅发送了一份 G&S 样本。分别有 56 例(12.4%)和 20 例(4.4%)患者发送了三份和四份 G&S 样本。只有两名患者在围手术期需要输血(0.4%),并且这两个患者的输血指征与主要手术无关。
这些结果表明,该患者队列的输血率接近零。省略 G&S 是安全的,并且可能节省时间和资源。