Harrow Simeon, Nadarajasundaram Aaruran
Surgery, Maidstone and Tunbridge Wells NHS Trust, Kent, GBR.
General Surgery, Croydon University Hospital, London, GBR.
Cureus. 2025 Jan 27;17(1):e78086. doi: 10.7759/cureus.78086. eCollection 2025 Jan.
Background Laparoscopic appendicectomy is a commonly used approach for the surgical management of acute appendicitis. If complications arise, a blood transfusion may be necessary for patients undergoing emergency appendicectomy. The need for routine group and save (G&S) sampling prior to emergency laparoscopic appendicectomy remains a subject of ongoing discussion. The aim of this study was to evaluate whether routine G&S sampling is needed prior to emergency laparoscopic appendicectomy. Methods The present study retrospectively reviewed G&S sampling for emergency laparoscopic appendicectomy cases over a six-month period at two hospital sites in the United Kingdom: Croydon University Hospital (June 1, 2024, to November 30, 2024) and Tunbridge Wells Hospital (October 1, 2023, to April 30, 2024). A total of 304 patients across both sites were included in the review. Results In 2023, 23 procedures (7.6%) were performed, while 279 procedures (92.4%) occurred in 2024. The patient population consisted of 46.4% males () and 53.6% females (), with a mean age of 37.1 years (median 33, range 6-84). A total of 406 G&S samples were collected, of which 351 (86.5%) were processed and 55 (13.5%) were rejected by the blood bank. From the sample size, only one patient received a blood transfusion prior to surgery due to a low hemoglobin level of 72 g/L, likely resulting from the delayed presentation of a perforated appendix. Conclusion This study suggests that omitting routine G&S sampling is safe for patients undergoing emergency laparoscopic appendicectomy. Hence, an individualized risk assessment approach should be used to identify high-risk patients requiring preoperative G&S sampling.
腹腔镜阑尾切除术是急性阑尾炎外科治疗的常用方法。如果出现并发症，急诊阑尾切除术患者可能需要输血。急诊腹腔镜阑尾切除术之前是否需要常规进行血型鉴定和交叉配血（G&S）采样仍是一个持续讨论的话题。本研究的目的是评估急诊腹腔镜阑尾切除术之前是否需要常规进行G&S采样。方法：本研究回顾性分析了英国两个医院在六个月期间急诊腹腔镜阑尾切除术病例的G&S采样情况：克罗伊登大学医院（2024年6月1日至2024年11月30日）和汤布里奇韦尔斯医院（2023年10月1日至2024年4月30日）。两个医院共304例患者纳入分析。结果：2023年进行了23例手术（7.6%），2024年进行了279例手术（92.4%）。患者群体中男性占46.4%，女性占53.6%，平均年龄37.1岁（中位数33岁，范围6 - 84岁）。共采集了406份G&S样本，其中351份（86.5%）被血库处理，55份（13.5%）被血库拒收。从样本量来看，只有一名患者因血红蛋白水平低至72 g/L在手术前接受了输血，这可能是由于阑尾穿孔就诊延迟所致。结论：本研究表明，对于接受急诊腹腔镜阑尾切除术的患者，省略常规G&S采样是安全的。因此，应采用个体化风险评估方法来识别需要术前进行G&S采样的高危患者。
