Blood transfusion requirement for gastric cancer surgery: reasonable preparation for transfusion in the comprehensive health insurance system.
We investigated the necessity of preparation for blood transfusion in gastric cancer surgery to save costs for blood typing, antibody screening, cross-matching, and disposal of the blood product. The subjects of the study were 52 patients who underwent gastric cancer surgery at our department between 2000 and 2004. The requirement for blood transfusion during surgery was investigated in terms of patient characteristics, hemoglobin before surgery, and performance status as well as treatment regimen. Furthermore, economic effects were investigated when typing and screening (T&S) were performed instead of typing and cross-matching (T&X). Of 9 patients who received blood transfusion, 8 had gastric cancer of stage IIIB or higher, or underwent combined resection. Blood transfusion was not used in surgery for patients with early gastric cancer. The volumes of blood prepared, lost, and disposed of in 28 patients who underwent T&X were 831.3+/-249.4, 219.3+/-228.5 and 600+/-333.1 ml, respectively, whereas the blood loss in 24 patients who underwent T&S was 161.1+/-95.6 ml; this difference had a major economic effect. The practice of T&S for patients undergoing gastric surgery in the absence of combined resection for early gastric cancer seems to be a safe and cost-effective practice that abrogates disposal of blood in hospital management.
Department of Surgery, National Hospital Organization, Utsunomiya National Hospital, Tochigi, Japan. hoya@jikei.ac.jp
Yoshiyuki
Y
Hoya
Tomoko
T
Takahashi
Ryouta
R
Saitoh
Tadashi
T
Anan
Toshiyuki
T
Sasaki
Takuya
T
Inagaki
Satoshi
S
Yamazaki
Makoto
M
Yamashita
Katsuhiko
K
Yanaga
D000368:Aged; D001788:Blood Grouping and Crossmatching / Q000191:economics; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D005260:Female; D005743:Gastrectomy; D006801:Humans; D007564:Japan; D008297:Male; D009313:National Health Programs; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*