Patient Blood Management and Thoracic, Esophageal, and Lung Surgery
An Interview with Ghulam Abbas, MD
Dr. Ghulam Abbas is chair of the Department of Surgery at UPMC Passavant and specializes in thoracic, esophageal, and lung surgery.
What are your feelings about the use of blood transfusions?
There are certain situations where blood transfusion is a life-saving intervention. That said, as a physician I see benefits to minimizing or avoiding blood transfusions in all of my patients. That is one reason why we are so interested in minimally invasive surgery at UPMC Passavant. Minimally invasive surgery is often associated with less blood loss and less use of transfusions.
For some patients, transfusion is not an option. I have treated many patients who were not able to receive blood transfusions. I feel that it is important to treat the whole person, respecting their beliefs, culture and wishes.
I therefore find it important to have my patients who refuse transfusions talk with staff at The UPMC Center for Bloodless Medicine and Surgery so that I can have a clear picture of the wishes of each particular patient. From this, I am able to make a treatment plan that also respects the patient’s wishes and beliefs.
Can you provide examples of minimally invasive thoracic surgery?
Many surgeries can be done using a keyhole approach. This means using small, five-millimeter-long incisions through which we can do operations, including minimally invasive resection of esophageal cancer and laparoscopic repair of hiatal hernias.
Another form of minimally invasive surgery is robotic surgery. Robotic surgery can be utilized for resection of mediastinal and lung tumors. Where indicated, robotic surgery can result in better resection of these tumors and less rib pain for the patient.
Yet another example of minimally invasive surgery is endoscopic surgery. Patients with early stage esophageal cancer may be candidates for such treatment. Often this approach allows patients to go home the same day as their procedure.
Dr. Abbas, you are involved in the Patient Blood Management program at UPMC Passavant. Please explain what “Patient Blood Management” is and why this interests you.
Patient Blood Management refers to our efforts to reduce the use of blood transfusions for all patients. In general, patients do better when transfusions are able to be avoided. For instance, there is evidence that patients with cancer do better when we can avoid transfusing them.
Therefore, we look to employ multiple techniques to reduce transfusions for all of our patients. We estimate that 25 percent of patients who are scheduled for surgery have a low blood count. Since patients who start surgery with anemia (a low blood count) are more likely to require transfusions, one avenue that we are actively pursuing is evaluating all surgical patients for anemia.
We then develop a treatment plan for the patient when anemia is found. When combining this approach with other blood sparing techniques, we believe that a majority of surgical patients can have their needs addressed without the need for a blood transfusion.
How can a patient have you evaluate his or her case?
You may contact my office at 412-367-6454. For a patient who refuses transfusions, it will be helpful to contact The UPMC Center for Bloodless Medicine and Surgery at 877-674-7111 in advance of their appointment with me.