Cross-matched blood in elective colorectal surgery: a wasted resource?: LTP12


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Abstract

Aim:Because of the risk of bleeding blood is always cross-matched for elective colorectal surgery but may be unused and wasted. Traditional cross-matching takes up to 45 min and transfusion departments canprovide electronically issued blood (EIB) to > 95% patients within 10 min. The purpose of this study was to examine whether cross-matching blood for all colorectalprocedures is justified.Method:Retrospective observational study included 164 consecutive patients (44 men, 24 women; median age 68 years) who underwent major colorectal intervention. Demographic and operative data, number of units of blood cross-matched and used, reasons for transfusion were analysed.Results:Surgicalprocedures performed were anterior resection (28%), right hemicolectomy (25%), sigmoid colectomy (20%), reversal of Hartmann's (9%) and other colorectal resection (18%). The majority (78%) of patients were suitable for EIB. Blood transfusionproved necessary in only 21 patients (13%) and was post-operative in 12 of them. One patient required an emergency transfusion and remaining received blood [non-urgently].Conclusion:Very small numbers of patients undergoing elective colorectal surgery require blood transfusions, most of which are needed non-urgently. Patients suitable for EIB should not be crossmatched bloodpreoperatively. Increasing suitability for EIB will allow the majority of patients to undergo surgery safely without routine cross matching of blood.

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