title: Blood transfusion requirements for endoscopic sinonasal inverted papilloma resections.
abstract: BACKGROUND
  Endoscopic resection of sinonasal Inverted Papilloma (SNIP) tumors has been shown to reduce intra-operative blood loss and recovery time compared to open approaches. The purpose of this study is to investigate the incidence and requirements of blood transfusion for endoscopic SNIP surgeries.
  
  
  METHODS
  An individual retrospective cohort study of endoscopic SNIP surgeries over a 10-year period was performed. Age, sex, pre-existing co-morbidity, use of anti-coagulants, tumor type and stage, time of surgery, estimated blood loss and the requirement for blood transfusion were recorded.
  
  
  RESULTS
  82 patients were included (57 males, 25 females). 4 (5%) Stage 1, 7 (8.5%) Stage 2, 62 (75.5%) Stage 3 and 9 (11%) Stage 4 SNIP tumors were identified according to the Krouse staging system. 3 (4%) patients required blood transfusion. 3 of the 9 (33%) Stage 4 tumors required blood transfusion. Stage 4 tumors were significantly associated with blood transfusion (p < 0.05). Higher staged tumors were associated with greater blood loss (p < 0.05) than lower staged cases. No other tumor stage required blood transfusion and no other pre-operative variable was associated with requirement for blood transfusion.
  
  
  CONCLUSIONS
  Endoscopic SNIP resections rarely require blood transfusions. No pre-operative factor other than tumor stage is associated with the requirement for blood transfusion. We would therefore suggest that only Stage 4 SNIP tumors require pre-operative type and screen.
authors.affiliation: Division of Otolaryngology, University of British Columbia, St, Paul's Sinus Centre, 1081 Burrard Street, Vancouver BC V6Z 1Y6, Canada. arhabib9@gmail.com.
authors.forename: Al-Rahim R
authors.initials: AR
authors.lastname: Habib
authors.forename: Iain
authors.initials: I
authors.lastname: Hathorn
authors.forename: Vishnu S
authors.initials: VS
authors.lastname: Sunkaraneni
authors.forename: Aviva
authors.initials: A
authors.lastname: Srubiski
authors.forename: Amin R
authors.initials: AR
authors.lastname: Javer
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D018308:Papilloma, Inverted / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies