Is routine blood cross-matching necessary in elective laparoscopic colorectal surgery?

Diane R Hildebrand, Norman R Binnie, Emad H Aly

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

BACKGROUND: Routine pre-operative cross-matching of two units of packed red cells (PRC) is current practice in most hospitals for patients undergoing elective laparoscopic colorectal surgery (LCS).

AIMS: To determine the usage of PRC in patients undergoing elective LCS & its cost implications.

METHODS: Retrospective analysis of 116 consecutive laparoscopic colorectal resections under the care of 2 consultant surgeons.

RESULTS: Surgical procedures were anterior resection (31.9%; n = 37), right hemicolectomy (22.4%; n = 26), sigmoid colectomy (22.4%; n-26), subtotal colectomy (7.8%; n = 9), APR (4.3%; n = 5), panproctocolectomy (3.4%; n = 4), completion proctectomy (1.7%, n = 2), left hemicolectomy (0.9%, n = 1), total colectomy (0.9%; n = 1) & resection rectopexy (0.9%; n = 1). The median age was 65 years, 58% female. The median pre-operative haemoglobin was 131 g/L, median blood loss 100 ml and median post-operative haemoglobin 111.5 g/L. Eleven cases were converted. Three patients required perioperative blood transfusion, 2 of whom underwent open conversion. The cost of carrying out a group & save (G&S) in our hospital is £40.60 excluding laboratory staff labour cost. A 2 unit cross-match costs £294.60. There is potential for substantial cost savings with change of practice to G&S only.

CONCLUSION: G&S is sufficient to allow safe & cost-effective operative practice in laparoscopic colorectal surgery.

Original languageEnglish
Pages (from-to)92-95
Number of pages4
JournalInternational Journal of Surgery
Volume10
Issue number2
Early online date8 Jan 2012
DOIs
Publication statusPublished - 2012

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Colorectal Surgery
Laparoscopy
Colectomy
Costs and Cost Analysis
Hemoglobins
Cost Savings
Sigmoid Colon
Consultants
Blood Transfusion

Keywords

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Loss, Surgical
  • Blood Transfusion
  • Colectomy
  • Elective Surgical Procedures
  • Erythrocyte Indices
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Preoperative Care
  • Rectum
  • Retrospective Studies
  • Scotland
  • Young Adult
  • Evaluation Studies
  • Journal Article

Cite this

Is routine blood cross-matching necessary in elective laparoscopic colorectal surgery? / Hildebrand, Diane R; Binnie, Norman R; Aly, Emad H.

In: International Journal of Surgery , Vol. 10, No. 2, 2012, p. 92-95.

Research output: Contribution to journalArticle

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title = "Is routine blood cross-matching necessary in elective laparoscopic colorectal surgery?",
abstract = "BACKGROUND: Routine pre-operative cross-matching of two units of packed red cells (PRC) is current practice in most hospitals for patients undergoing elective laparoscopic colorectal surgery (LCS).AIMS: To determine the usage of PRC in patients undergoing elective LCS & its cost implications.METHODS: Retrospective analysis of 116 consecutive laparoscopic colorectal resections under the care of 2 consultant surgeons.RESULTS: Surgical procedures were anterior resection (31.9{\%}; n = 37), right hemicolectomy (22.4{\%}; n = 26), sigmoid colectomy (22.4{\%}; n-26), subtotal colectomy (7.8{\%}; n = 9), APR (4.3{\%}; n = 5), panproctocolectomy (3.4{\%}; n = 4), completion proctectomy (1.7{\%}, n = 2), left hemicolectomy (0.9{\%}, n = 1), total colectomy (0.9{\%}; n = 1) & resection rectopexy (0.9{\%}; n = 1). The median age was 65 years, 58{\%} female. The median pre-operative haemoglobin was 131 g/L, median blood loss 100 ml and median post-operative haemoglobin 111.5 g/L. Eleven cases were converted. Three patients required perioperative blood transfusion, 2 of whom underwent open conversion. The cost of carrying out a group & save (G&S) in our hospital is £40.60 excluding laboratory staff labour cost. A 2 unit cross-match costs £294.60. There is potential for substantial cost savings with change of practice to G&S only.CONCLUSION: G&S is sufficient to allow safe & cost-effective operative practice in laparoscopic colorectal surgery.",
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author = "Hildebrand, {Diane R} and Binnie, {Norman R} and Aly, {Emad H}",
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T1 - Is routine blood cross-matching necessary in elective laparoscopic colorectal surgery?

AU - Hildebrand, Diane R

AU - Binnie, Norman R

AU - Aly, Emad H

N1 - Copyright © 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

PY - 2012

Y1 - 2012

N2 - BACKGROUND: Routine pre-operative cross-matching of two units of packed red cells (PRC) is current practice in most hospitals for patients undergoing elective laparoscopic colorectal surgery (LCS).AIMS: To determine the usage of PRC in patients undergoing elective LCS & its cost implications.METHODS: Retrospective analysis of 116 consecutive laparoscopic colorectal resections under the care of 2 consultant surgeons.RESULTS: Surgical procedures were anterior resection (31.9%; n = 37), right hemicolectomy (22.4%; n = 26), sigmoid colectomy (22.4%; n-26), subtotal colectomy (7.8%; n = 9), APR (4.3%; n = 5), panproctocolectomy (3.4%; n = 4), completion proctectomy (1.7%, n = 2), left hemicolectomy (0.9%, n = 1), total colectomy (0.9%; n = 1) & resection rectopexy (0.9%; n = 1). The median age was 65 years, 58% female. The median pre-operative haemoglobin was 131 g/L, median blood loss 100 ml and median post-operative haemoglobin 111.5 g/L. Eleven cases were converted. Three patients required perioperative blood transfusion, 2 of whom underwent open conversion. The cost of carrying out a group & save (G&S) in our hospital is £40.60 excluding laboratory staff labour cost. A 2 unit cross-match costs £294.60. There is potential for substantial cost savings with change of practice to G&S only.CONCLUSION: G&S is sufficient to allow safe & cost-effective operative practice in laparoscopic colorectal surgery.

AB - BACKGROUND: Routine pre-operative cross-matching of two units of packed red cells (PRC) is current practice in most hospitals for patients undergoing elective laparoscopic colorectal surgery (LCS).AIMS: To determine the usage of PRC in patients undergoing elective LCS & its cost implications.METHODS: Retrospective analysis of 116 consecutive laparoscopic colorectal resections under the care of 2 consultant surgeons.RESULTS: Surgical procedures were anterior resection (31.9%; n = 37), right hemicolectomy (22.4%; n = 26), sigmoid colectomy (22.4%; n-26), subtotal colectomy (7.8%; n = 9), APR (4.3%; n = 5), panproctocolectomy (3.4%; n = 4), completion proctectomy (1.7%, n = 2), left hemicolectomy (0.9%, n = 1), total colectomy (0.9%; n = 1) & resection rectopexy (0.9%; n = 1). The median age was 65 years, 58% female. The median pre-operative haemoglobin was 131 g/L, median blood loss 100 ml and median post-operative haemoglobin 111.5 g/L. Eleven cases were converted. Three patients required perioperative blood transfusion, 2 of whom underwent open conversion. The cost of carrying out a group & save (G&S) in our hospital is £40.60 excluding laboratory staff labour cost. A 2 unit cross-match costs £294.60. There is potential for substantial cost savings with change of practice to G&S only.CONCLUSION: G&S is sufficient to allow safe & cost-effective operative practice in laparoscopic colorectal surgery.

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JO - International Journal of Surgery

JF - International Journal of Surgery

SN - 1743-9159

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