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Patient Blood Management in Transurethral Resection Surgery: Overview and Strategy Analysis from a French Tertiary Hospital.
Pastene, Bruno; Bernard, Raphaël; Colin, Manon; Zunino, Claire; Chabert-Vaudran, Lénaïck; Bastide, Cyrille; Zieleskiewicz, Laurent; Leone, Marc.
Afiliación
  • Pastene B; Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France. bruno.pastene@ap-hm.fr.
  • Bernard R; Centre for Cardiovascular and Nutrition Research (C2VN), INRA, Aix Marseille University, INSERM, Marseille, France. bruno.pastene@ap-hm.fr.
  • Colin M; Service d'anesthésie et réanimation-Hôpital Nord-Bâtiment Etoile 1er Étage, Chemin des Bourrely, 13015, Marseille, France. bruno.pastene@ap-hm.fr.
  • Zunino C; Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
  • Chabert-Vaudran L; Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
  • Bastide C; Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
  • Zieleskiewicz L; Department of Anesthesiology and Intensive Care, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
  • Leone M; Department of Urology, Hôpital Nord, Hôpitaux Universitaires de Marseille, Marseille, France.
Adv Ther ; 40(4): 1830-1837, 2023 04.
Article en En | MEDLINE | ID: mdl-36867328
INTRODUCTION: Since Patient blood management (PBM) suggests a bundle of measures aiming to reduce perioperative blood transfusion because preoperative anemia and blood transfusion are associated with poor postoperative outcomes. There is a lack of data on the effect of PBM in patients undergoing transurethral resection of prostate (TURP) or bladder tumor (TURBT). We aimed to assess the bleeding risk in TURP and TURBT procedures and the effect of preoperative anemia on postoperative morbimortality. METHODS: A single-center retrospective observational cohort study was conducted in a tertiary hospital in Marseille, France. All patients undergoing TURP or TURBT were included in 2020 and divided into two groups: preoperative anemia (n = 19) and no preoperative anemia (n = 59). We recorded demographic characteristics, preoperative hemoglobin concentration, iron deficiency markers, preoperative initiation of a treatment for anemia, perioperative bleeding, and postoperative outcomes up to 30 days including blood transfusion, hospital readmission, reintervention, infection, and mortality. RESULTS: Baseline characteristics were comparable between groups. No patient had iron deficiency markers and no prescription of iron was initiated before surgery. No major bleeding was reported during surgery. Postoperative anemia was found in 21 patients, including 16 (76%) in the preoperative anemia group and 5 (24%) in the non-preoperative anemia group. One patient of each group received a blood transfusion after surgery. No significant differences in 30-day outcomes were reported. CONCLUSION: Our study suggests that TURP and TURBT are not associated with a high-risk of postoperative bleeding. In such procedures, adherence PBM strategies do not seem beneficial. Since recent guidelines recommend restricting preoperative testing, our results may help to improve preoperative risk stratification.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperplasia Prostática / Resección Transuretral de la Próstata / Deficiencias de Hierro / Anemia Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans / Male Idioma: En Revista: Adv Ther Asunto de la revista: TERAPEUTICA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hiperplasia Prostática / Resección Transuretral de la Próstata / Deficiencias de Hierro / Anemia Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Humans / Male Idioma: En Revista: Adv Ther Asunto de la revista: TERAPEUTICA Año: 2023 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos