title: Blood management and radical retropubic prostatectomy: Quebec experience.
abstract: One of the concerns of patients undergoing radical retropubic prostatectomy (RRP) is the risk of intraoperative bleeding and the subsequent need of blood products. Patients can presently consider pre-operative autologuous blood donation (PAD) prior to elective urological oncology surgery to decrease the risk of allogenic transfusion. We reviewed the medical charts of 141 patients that had a RRP in the CHUQ-Pavillon Hôtel-Dieu de Québec in 1996 for prostate cancer. The average and median blood loss were respectively 804 cc and 650 cc, but more than 75% of patients lost less than 1,000 ml. Allogeneic transfusion was required in 11 (7.8%) patients. PAD was done in 45.4 %. The clinical characteristics of patients with PAD were similar to the patients who did not bank blood. The need for allogeneic transfusion was reduced to 3% (2/64) in the patients with PAD compared to 11.7% for the 77 patients without PAD. The average blood loss was higher in the 11 patients that received allogenic blood (1641 cc vs 734 cc, p < 0.01), but their average preoperative Hb was lower (127.9 vs 141.9, p < 0.01). These results suggest that there may be other effective methods in preventing the need for allogenic blood transfusion in RRP.
authors.affiliation: Urology Service, Surgery Department, CHUQ-Pavillon Hôtel-Dieu de Québec, Quebec City, Quebec, Canada.
authors.forename: Louis
authors.initials: L
authors.lastname: Lacombe
authors.forename: Yves
authors.initials: Y
authors.lastname: Fradet