title: Predicting blood transfusion in patients undergoing minimally invasive oesophagectomy.
abstract: OBJECTIVE
  To evaluate predictors of allogenic blood transfusion requirements in patients undergoing minimal invasive oesophagectomy at a tertiary high volume centre for oesophago-gastric surgery.
  
  
  METHODS
  Retrospective analysis of all patients undergoing minimal access oesophagectomy in our department between January 2010 and December 2011. Patients were divided into two groups depending on whether they required a blood transfusion at any time during their index admission. Factors that have been shown to influence perioperative blood transfusion requirements in major surgery were included in the analysis. Binary logistic regression analysis was performed to determine the impact of patient and perioperative characteristics on transfusion requirements during the index admission.
  
  
  RESULTS
  A total of 80 patients underwent minimal access oesophagectomy, of which 61 patients had a laparoscopic assisted oesophagectomy and 19 patients had a minimal invasive oesophagectomy. Perioperative blood transfusion was required in 28 patients at any time during hospital admission. On binary logistic regression analysis, a lower preoperative haemoglobin concentration (p < 0.01), suffering a significant complication (p < 0.005) and laparoscopic assisted oesophagectomy (p < 0.05) were independent predictors of blood transfusion requirements.
  
  
  CONCLUSIONS
  It has been reported that requirement for blood transfusion can affect long-term outcomes in oesophageal cancer resection. Two factors which could be addressed preoperatively; haemoglobin concentration and type of oesophageal resection, may be valuable in predicting blood transfusions in patients undergoing minimally invasive oesophagectomy.
  
  
  CONCLUSIONS
  Our analysis revealed that preoperative haemoglobin concentration, occurrence of significant complications and type of minimal access oesophagectomy predicted blood transfusion requirements in the patient population examined.
authors.affiliation: Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK. Electronic address: crispin.schneider.13@ucl.ac.uk.
authors.forename: Crispin
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
authors.forename: Alex P
authors.initials: AP
authors.lastname: Boddy
authors.affiliation: Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
authors.forename: Junaid
authors.initials: J
authors.lastname: Fukuta
authors.affiliation: Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
authors.forename: William D
authors.initials: WD
authors.lastname: Groom
authors.affiliation: Division of Surgery, Head and Neck, University Hospitals Bristol NHS Foundation Trust, Upper Maudlin Street, Bristol BS2 8HW, UK.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Streets
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data*; D004938:Esophageal Neoplasms / Q000097:blood* / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005260:Female; D006441:Hemoglobin A / Q000032:analysis*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D012044:Regression Analysis; D012189:Retrospective Studies
chemical_list: D006441:Hemoglobin A
keywords: Blood transfusion; Laparoscopic assisted oesophagectomy; Minimal invasive oesophagectomy; Preoperative haemoglobin concentration