Blood Use in Head and Neck Tumor Surgery: Potential for Autologous Blood

Abstract

\s=b\Recent increased concern regarding the risks of homologous blood transfusion led us to examine the use of blood products for head and neck tumor surgery. Major head and neck surgical procedures at three University of Washington (Seattle)\p=n-\ affiliated hospitals during 1987 were reviewed. Seventy-seven patients were identified. Parameters studied included the following: tumor site and stage, prior treatment, surgical procedure, preoperative and postoperative hematocrit values, estimated blood loss, operative and postoperative blood product use, and operative time. Data were grouped by procedure. Maxillectomy/midface procedures showed the highest average estimated blood loss (1037 mL) and the highest average blood use (1.5 units), followed by composite resections (883 mL and 0.8 units) and laryngectomies (724 mL and 0.9 units). When the data were subgrouped, larynogopharyngectomy (1450 mL and 4.0 units) and composite resection with mandibular swing (1300 mL and 1.0 units) showed the highest blood loss and blood product use. In the assessable groups, previous administration of radiation did not make a significant difference in blood loss or procedure time. However, blood loss correlated well with procedure time in all groups. The great majority of patients met all requirements to function as blood donors (84%). Sixty-five percent of patients met all criteria and used less than 2 units of blood, making autologous blood a reasonable option for the majority of patients with head and neck tumors.

Blood Transfusion Requirements in Otolaryngology-Head and Neck Surgery

“…Also, the intraoperative blood 'Ioss and the transfusion requirements for each operation were determined. Overall, these results correspond to the unique study published on the subject (17), although direct comparison is not possible because of a different classification of the primary ablative surgery and reconstruction procedure. Blood losses above 1,000 ml, which most likely require a blood transfusion, were encountered in composite resections for oral or oropharyngeal cancers, total laryngopharyngectomies, and maxillectomy procedures (17).…”

Predictive factors for perioperative blood transfusion in neck dissection

“…Significant bleeding from the neck is extremely rare in ND . Nevertheless, the preoperative elective surgical protocol in our department calls for two cross‐matched blood units to be prepared for each patient before an ND.…”

“…A small number of studies examined the need for preoperative cross‐matched blood for head and neck surgery . Based on their results, neck dissection (ND) alone rarely requires blood replacement; therefore, preoperative cross‐matching should not be carried out unless there are unusual circumstances . However, these unusual circumstances are not well investigated.…”

Prognostic impact of blood transfusion in patients undergoing primary surgery and free‐flap reconstruction for oral squamous cell carcinoma

“…Severe blood loss is common both in resection of OSCC and in neck dissection. Blood loss caused by tumor resection in the oral cavity ranges between 730 ± 456 mL and 1300 ± 566 mL 19. For unilateral neck dissection, an average blood loss of 337 ± 188 mL has been reported.…”