Open simple prostatectomy and blood transfusion in Nairobi

Area of Science:

• Urology
• Surgical Oncology
• Transfusion Medicine

Background:

• Open simple prostatectomy is linked to substantial perioperative blood loss, making allogeneic blood transfusion a common practice.
• Concerns regarding blood shortages, transfusion reactions, and disease transmission necessitate evaluating factors influencing blood loss and transfusion in this procedure.

Purpose of the Study:

• To assess blood loss and blood transfusion rates in open simple prostatectomy.
• To identify patient-related factors associated with perioperative blood loss and transfusion requirements.

Main Methods:

• A prospective cohort study was conducted.
• The study involved 95 patients undergoing open simple prostatectomy for benign prostatic hyperplasia at Kenyatta National Hospital, Kenya.

Main Results:

• The mean decrease in hemoglobin was 2.1 g/dl, with a perioperative blood transfusion rate of 36.8%.
• Factors associated with increased blood loss included age over 70, use of anticoagulants, higher systolic blood pressure, general anesthesia, Freyer's technique, and larger resected prostate weight.
• Two postoperative deaths (2.1%) occurred in patients with severe bleeding, massive transfusion, and disseminated intravascular coagulopathy.

Conclusions:

• Open simple prostatectomy under spinal anesthesia using Millin's retropubic technique is associated with minimal blood loss.
• The perioperative blood transfusion rate was 36.8%, with identified risk factors for increased bleeding.