Blood transfusion requirements for endoscopic sinonasal inverted papilloma resections

Endoscopic resection of sinonasal inverted papilloma (SNIP) tumours has been shown to reduce intraoperative blood loss and recovery time compared to open approaches.

The purpose of this study was to investigate the incidence and requirements of blood transfusion for endoscopic SNIP surgeries.

Individual retrospective cohort study.

St. Paul's Sinus Centre, a tertiary referral rhinology centre.

An individual retrospective cohort study of endoscopic SNIP surgeries over a 10-year period was performed. Age, sex, pre-existing comorbidity, use of anticoagulants, tumour type and stage, time of surgery, estimated blood loss, and requirement for blood transfusion were recorded.

Incidence of blood transfusion, type and screen, and crossmatch requisitions.

Eighty-two patients were included (57 males, 25 females). Four (5%) stage 1, 7 (8.5%) stage 2, 62 (75.5%) stage 3, and 9 (11%) stage 4 SNIP tumours were identified according to the Krouse staging system. Three (4%) patients required blood transfusion. Three of the nine (33%) stage 4 tumours required blood transfusion. Stage 4 tumours were significantly associated with blood transfusion (p < .05). Higher-staged tumours were associated with greater blood loss (p < .05) than lower-staged cases. No other tumour stage required blood transfusion, and no other preoperative variable was associated with the requirement for blood transfusion.

Endoscopic SNIP resections rarely require blood transfusions. No preoperative factor other than tumour stage is associated with the requirement for blood transfusion. We therefore suggest that only stage 4 SNIP tumours require preoperative type and screen testing.