The Factors Related to Blood Loss during Endoscopic Sinus Surgery

Background:The safety and efficacy of endoscopic sinus surgery have improved with the development of new equipment and improved surgical techniques.However, it is accompanied by the risk of complications.Intra-operative blood loss is an important factor for the safe conduct of surgery.Therefore, we examined the factors associated with intra-operative blood loss. Method:The amount of intra-operative bleeding experienced by 518 patients with sinonasal disease who underwent endoscopic sinus surgery under general anaesthesia at our hospital over 9 years was tabulated.Thirty-four variables were extracted after analysis of the patients' background, sinonasal pathology, and haematology results.Multivariate linear regression analysis was performed.Results: Multivariate analysis revealed significant differences in the prothrombin time-international normalised ratio (PT-INR), Lund-Mackay score, operative time, and initial versus repeat surgery.The degree of change between the 25% and 75% points was significant for the following variables: an increase from 5 to 14 points for the Lund-Mackay score at 73.0 mL. Conclusions:Preoperative precautionary measures should be implemented in the event of re-operation, expected prolonged operative time, high Lund-Mackay score, and prolonged PT-INR.Intra-operative blood loss in patients with a high Lund-Mackay score requires meticulous attention.