Blood transfusion requirements for endoscopic sinonasal inverted papilloma resections.

BACKGROUND: Endoscopic resection of sinonasal inverted papilloma (SNIP) tumours has been shown to reduce intraoperative blood loss and recovery time compared to open approaches.

OBJECTIVE: The purpose of this study was to investigate the incidence and requirements of blood transfusion for endoscopic SNIP surgeries.

STUDY DESIGN: Individual retrospective cohort study.

SETTING: St. Paul's Sinus Centre, a tertiary referral rhinology centre.

METHODS: An individual retrospective cohort study of endoscopic SNIP surgeries over a 10-year period was performed. Age, sex, pre-existing comorbidity, use of anticoagulants, tumour type and stage, time of surgery, estimated blood loss, and requirement for blood transfusion were recorded.

MAIN OUTCOME MEASURES: Incidence of blood transfusion, type and screen, and crossmatch requisitions.

RESULTS: Eighty-two patients were included (57 males, 25 females). Four (5%) stage 1, 7 (8.5%) stage 2, 62 (75.5%) stage 3, and 9 (11%) stage 4 SNIP tumours were identified according to the Krouse staging system. Three (4%) patients required blood transfusion. Three of the nine (33%) stage 4 tumours required blood transfusion. Stage 4 tumours were significantly associated with blood transfusion (p < .05). Higher-staged tumours were associated with greater blood loss (p < .05) than lower-staged cases. No other tumour stage required blood transfusion, and no other preoperative variable was associated with the requirement for blood transfusion.

CONCLUSION: Endoscopic SNIP resections rarely require blood transfusions. No preoperative factor other than tumour stage is associated with the requirement for blood transfusion. We therefore suggest that only stage 4 SNIP tumours require preoperative type and screen testing.