London North West University Healthcare NHS Trust, Harrow, UK.
The Hillingdon Hospitals NHS foundation Trust, Uxbridge, UK.
J Perioper Pract. 2023 May;33(5):153-157. doi: 10.1177/17504589221110333. Epub 2022 Aug 8.
Two valid group and saves are commonly required for patients undergoing laparoscopic appendicectomy and laparoscopic hernia repairs preoperatively; however, perioperative blood transfusions are seldom required. This is financially burdensome and frequently leads to delays in theatre lists. We performed a retrospective analysis to investigate blood transfusions performed perioperatively and within 28 days of these procedures.
We used our electronic records to collect data of all laparoscopic appendectomies and laparoscopic hernia repairs between March 2017 and March 2021. Patients of any age undergoing these operations were included. Patients requiring concomitant intra-abdominal surgery or who had incomplete medical records were excluded.
A total of 1891 patients were included, of which 1462 (77.3%) had a laparoscopic appendicectomy versus 429 (22.7%) who had a laparoscopic hernia repair. In all, 3507 group and saves were taken costing £47,398.50. One patient (0.068%) required emergency blood transfusion (4 units of red cells) secondary to major haemorrhage.
Our findings demonstrate that the incidence of perioperative blood transfusions for laparoscopic appendicectomy and laparoscopic hernia repairs is low, challenging the indication for routine preoperative group and saves.
行腹腔镜阑尾切除术和腹腔镜疝修补术的患者通常需要两组及以上的备用血才能满足术前需要；但实际上，这些手术术中及术后 28 天内很少需要输血。这既耗费财力，又经常导致手术安排延迟。我们进行了一项回顾性分析，旨在调查这些手术中进行的围手术期输血情况。
我们使用电子病历收集了 2017 年 3 月至 2021 年 3 月间所有腹腔镜阑尾切除术和腹腔镜疝修补术患者的数据。纳入所有年龄的接受这些手术的患者。排除需要同时进行腹腔内手术或病历不完整的患者。
共纳入 1891 例患者，其中 1462 例（77.3%）行腹腔镜阑尾切除术，429 例（22.7%）行腹腔镜疝修补术。总共采集了 3507 组及以上备用血，花费为 47398.50 英镑。1 例（0.068%）患者因大出血需要紧急输血（4 单位红细胞）。
我们的研究结果表明，腹腔镜阑尾切除术和腹腔镜疝修补术围手术期输血的发生率较低，对常规术前备血的适应证提出了挑战。
