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Is group and saving before the modern bipolar transurethral resection of the prostate still necessary?
Damola, Adebiyi Libotte, Chloe Ehsanullah, Syed Ali Jones, Adam Apakama, Ike
Damola, Adebiyi
Libotte, Chloe
Ehsanullah, Syed Ali
Jones, Adam
Apakama, Ike
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Affiliation
University Hospitals Birmingham NHS Foundation Trust; University College London; George Eliot Hospital NHS Trust, Nuneaton; University of Warwick; Royal Berkshire NHS Foundation Trust
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Publication date
2022-08-26
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Abstract
Introduction: Group and save (G&S) sampling is commonplace for patients undergoing transurethral resection of the prostate (TURP) due to the historically high risk of bleeding. However, modern adjustments to the procedure, including the advent of bipolar TURP in saline, have significantly reduced this risk. This study assessed whether routinely performing G&Ss before the modern TURP is still appropriate.
Materials and Methods: This study was a retrospective review of all patients who underwent a TURP from January 2009 until December 2019 in one centre. A total of 687 patients were identified during this period. In addition, data was collected on G&S samples, blood products, and postoperative complications such as clot retention or if patients required a blood transfusion.
Results: All patients had G&S samples taken before their operation. Only six (0.87%) patients required a blood transfusion. Half were transfused intra-operatively and half post-operatively. Remarkably, none of the transfused patients were below the National Institute for Health and Care Excellence (NICE) threshold to transfuse of <70g/L(8). Six patients were also noted to develop clot retention following the catheter removal.
Discussion and Conclusion: This study has determined that patients undergoing a TURP rarely require blood transfusions. We propose that the practice of routinely taking G&S samples before this procedure should be reviewed. This would give a financial benefit and relieve patients of the unnecessary test. We would recommend thorough optimisation of patients before surgery, including review of anticoagulation and correction of any preoperative anaemia.
Citation
Kretzmer L, Damola A, Libotte C, Ehsanullah SA, Jones A, Apakama I. Is Group and Saving Before the Modern Bipolar Transurethral Resection of the Prostate Still Necessary?. Journal of Endoluminal Endourology. 2022 Aug 26;5(2):e44-8. doi: 10.22374/jeleu.v5i2.150.
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Article