Are Routine Blood Group and Save Samples Needed for Laparoscopic Day Case Surgery?

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2016 Feb 25

PMID 26908243

Citations 6

Authors

Peter M Thomson

Jack Ross

Samrat Mukherjee

Borzoueh Mohammadi

Affiliations

Soon will be listed here.

Abstract

Background: Common day case laparoscopic procedures are usually safe, with low rates of bleeding complications. At our trust, most patients undergo pre-operative group and save (G&S) for these procedures, at a cost of £18.39 per sample excluding laboratory staffing costs. Our aim was to assess if routine G&S is indicated.

Methods: We performed a retrospective review of all patients who underwent laparoscopic cholecystectomy (LC), laparoscopic inguinal hernia repair (LIH) and diagnostic laparoscopy (DL) in our institution between April 2012 and March 2014. Patients were identified using hospital coding records. Transfusion department records were reviewed to see which patients had undergone pre-operative G&S or cross-match, and peri-operative transfusion.

Results: Five hundred and thirty-two procedures were performed in 2 years: 293 LC, 123 LIH and 116 DL. G&S was performed in 256 (87 %; LC), 67 (54 %; LIH) and 88 (76 %; DL), respectively. Zero patients were transfused for bleeding complications. One patient was transfused following diagnostic laparoscopy to optimise pre-existing anaemia. The total cost of G&S over the study period was £7558.

Conclusion: Blood transfusion rates for bleeding complications following laparoscopic day case surgery are 0 % in our unit. G&S samples for these procedures cost £7558 over 2 years. Abandoning pre-operative G&S for these patients appears to be clinically indicated and would lead to substantial financial savings.

Citing Articles

Is Routine Group and Save Sampling Necessary for Emergency Laparoscopic Appendicectomy?.

Harrow S, Nadarajasundaram A Cureus. 2025; 17(1):e78086.

PMID: 39882197 PMC: 11774625. DOI: 10.7759/cureus.78086.

The Role of Group and Save Testing Prior to Emergency Laparoscopic Appendicectomy.

Chaudhari V, Mohammad H, Khan U Cureus. 2025; 16(12):e74898.

PMID: 39742180 PMC: 11686453. DOI: 10.7759/cureus.74898.

Assessment of routine pre-operative group and save testing in patients undergoing cholecystectomy: a retrospective cohort study.

OLeary L, Sherwood W, Fadel M, Barkeji M NIHR Open Res. 2024; 4:17.

PMID: 39473540 PMC: 11519620. DOI: 10.3310/nihropenres.13543.2.

A Retrospective Study of Routine Preoperative Blood Grouping and Saving in Laparoscopic Surgeries: A Minimally Utilized Expenditure.

Ramasamy S, Bylapudi S, Kumar S, Singh J, Harvitkar R, Gattupalli G Cureus. 2024; 16(9):e68557.

PMID: 39364467 PMC: 11449458. DOI: 10.7759/cureus.68557.

Pre-Operative Group and Save in Elective and Emergency Laparoscopic Cholecystectomy: Necessity, Cost-Effectiveness, and Own Experience.

Hamid M, Kershaw M, Bhakthavalsalan R, Shivamurthy R, Davies S, Singhal R J Clin Med. 2024; 13(10).

PMID: 38792291 PMC: 11122548. DOI: 10.3390/jcm13102749.

References

Veldkamp R, Kuhry E, Hop W, Jeekel J, Kazemier G, Bonjer H . Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005; 6(7):477-84. DOI: 10.1016/S1470-2045(05)70221-7. View

Wang P, Lee W, Yuan C, Chao H, Liu W, Yu K . Major complications of operative and diagnostic laparoscopy for gynecologic disease. J Am Assoc Gynecol Laparosc. 2001; 8(1):68-73. DOI: 10.1016/s1074-3804(05)60551-8. View

Duca S, Bala O, Al-Hajjar N, Lancu C, Puia I, Munteanu D . Laparoscopic cholecystectomy: incidents and complications. A retrospective analysis of 9542 consecutive laparoscopic operations. HPB (Oxford). 2008; 5(3):152-8. PMC: 2020579. DOI: 10.1080/13651820310015293. View

Chang L, Stefanidis D, Richardson W, Earle D, Fanelli R . The role of staging laparoscopy for intraabdominal cancers: an evidence-based review. Surg Endosc. 2008; 23(2):231-41. DOI: 10.1007/s00464-008-0099-2. View

Deng Y, Zhang Y, Guo T . Laparoscopy-assisted versus open distal gastrectomy for early gastric cancer: A meta-analysis based on seven randomized controlled trials. Surg Oncol. 2015; 24(2):71-7. DOI: 10.1016/j.suronc.2015.02.003. View

Singh J, Singh P . Routine pre-operative cross-match for elective colorectal resections: an appropriate use of resources?. Surgeon. 2011; 9(1):8-12. DOI: 10.1016/j.surge.2010.06.008. View

Prichard R, OKeefe M, McLaughlin R, Malone C, Sweeney K, Kerin M . A study of pre-operative type and screen in breast surgery: improved efficiency and cost saving. Ir J Med Sci. 2011; 180(2):513-6. DOI: 10.1007/s11845-010-0668-y. View

Dolce C, Keller J, Christian Walters K, Griffin D, Norton H, Heniford B . Laparoscopic versus open live donor nephrectomy: outcomes analysis of 266 consecutive patients. Surg Endosc. 2009; 23(7):1564-8. DOI: 10.1007/s00464-009-0340-7. View

Huh J, Kim H . Laparoscopic total colectomy using left-to-right dissection: comparison with the conventional open approach. Surg Laparosc Endosc Percutan Tech. 2011; 21(2):94-7. DOI: 10.1097/SLE.0b013e318211ae87. View

10.

Usal H, Nabagiez J, Sayad P, Ferzli G . Cost effectiveness of routine type and screen testing before laparoscopic cholecystectomy. Surg Endosc. 1999; 13(2):146-7. DOI: 10.1007/s004649900925. View

11.

Jeong W, Rha K, Kim H, Byun S, Kwon T, Seo I . Comparison of laparoscopic radical nephrectomy and open radical nephrectomy for pathologic stage T1 and T2 renal cell carcinoma with clear cell histologic features: a multi-institutional study. Urology. 2010; 77(4):819-24. DOI: 10.1016/j.urology.2010.06.024. View

12.

Usal H, Sayad P, Hayek N, Hallak A, Huie F, Ferzli G . Major vascular injuries during laparoscopic cholecystectomy. An institutional review of experience with 2589 procedures and literature review. Surg Endosc. 1998; 12(7):960-2. DOI: 10.1007/s004649900756. View

13.

Sinha S, Hofman D, Stoker D, Friend P, Poloniecki J, Thompson M . Epidemiological study of provision of cholecystectomy in England from 2000 to 2009: retrospective analysis of Hospital Episode Statistics. Surg Endosc. 2012; 27(1):162-75. DOI: 10.1007/s00464-012-2415-0. View

14.

Ball C, MacLean A, Kirkpatrick A, Bathe O, Sutherland F, Debru E . Hepatic vein injury during laparoscopic cholecystectomy: the unappreciated proximity of the middle hepatic vein to the gallbladder bed. J Gastrointest Surg. 2006; 10(8):1151-5. DOI: 10.1016/j.gassur.2006.04.012. View

15.

Wilson C, Bhatti A, Rix D, Soomro N . Comparison of laparoscopic and open donor nephrectomy: UK experience. BJU Int. 2005; 95(1):131-5. DOI: 10.1111/j.1464-410X.2004.05264.x. View

16.

Drymousis P, Raptis D, Spalding D, Fernandez-Cruz L, Menon D, Breitenstein S . Laparoscopic versus open pancreas resection for pancreatic neuroendocrine tumours: a systematic review and meta-analysis. HPB (Oxford). 2013; 16(5):397-406. PMC: 4008158. DOI: 10.1111/hpb.12162. View

17.

Kelly K, Selby L, Chou J, Dukleska K, Capanu M, Coit D . Laparoscopic Versus Open Gastrectomy for Gastric Adenocarcinoma in the West: A Case-Control Study. Ann Surg Oncol. 2015; 22(11):3590-6. PMC: 5050554. DOI: 10.1245/s10434-015-4381-y. View

18.

Veenhof A, Engel A, Craanen M, Meijer S, de Lange-de Klerk E, van der Peet D . Laparoscopic versus open total mesorectal excision: a comparative study on short-term outcomes. A single-institution experience regarding anterior resections and abdominoperineal resections. Dig Surg. 2007; 24(5):367-74. DOI: 10.1159/000107778. View

19.

Hildebrand D, Binnie N, Aly E . Is routine blood cross-matching necessary in elective laparoscopic colorectal surgery?. Int J Surg. 2012; 10(2):92-5. DOI: 10.1016/j.ijsu.2011.12.009. View

20.

Malik H, Bishop H, Winstanley J . Audit of blood transfusion in elective breast cancer surgery--do we need to group and save pre-operatively?. Ann R Coll Surg Engl. 2008; 90(6):472-3. PMC: 2647238. DOI: 10.1308/003588408X301091. View