title: Are Routine Blood Group and Save Samples Needed for Laparoscopic Day Case Surgery?
abstract: 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.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: Department of Upper GI Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK. peter.thomson1@nhs.net.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Thomson
authors.affiliation: Department of Upper GI Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK.
authors.forename: Jack
authors.initials: J
authors.lastname: Ross
authors.affiliation: Department of Upper GI Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK.
authors.forename: Samrat
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Department of Upper GI Surgery, University College London Hospitals NHS Foundation Trust, 235 Euston Road, Fitzrovia, London, NW1 2BU, UK.
authors.forename: Borzoueh
authors.initials: B
authors.lastname: Mohammadi
mesh_terms: D000556:Ambulatory Surgical Procedures / Q000009:adverse effects; D001789:Blood Group Antigens / Q000032:analysis*; D016063:Blood Loss, Surgical; D001803:Blood Transfusion / Q000706:statistics & numerical data; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects; D017048:Health Care Costs; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000009:adverse effects; D006801:Humans; D011300:Preoperative Care / Q000191:economics*; D012189:Retrospective Studies
chemical_list: D001789:Blood Group Antigens