Preoperative iron supplementation and intraoperative transfusion during colorectal cancer surgery.
OBJECTIVE
To investigative whether giving an iron preparation to anemic patients before colorectal cancer surgery improves their anemia and reduces the need for intraoperative blood transfusion.


METHODS
Among 569 patients who underwent colorectal cancer surgery between 1998 and 2003, we studied 32 anemic patients who received iron supplementation for at least 2 weeks preoperatively (group A) and 84 anemic patients who did not (group B). Anemia was defined as a hemoglobin (Hb) level at first presentation of </=10.0 g/dl. Hemoglobin and hematocrit (Ht) levels were measured at first presentation, then immediately before and after surgery. We also calculated intraoperative blood loss and compared intraoperative transfusion rates.


RESULTS
There were no significant differences between groups A and B in age, sex, surgical technique, tumor stage, and operating time. Their Hb and Ht values were similar at first presentation, but significantly different immediately before surgery (both P < 0.0001). There were no significant differences in intraoperative blood loss between the groups, but significantly fewer patients in group A needed an intraoperative blood transfusion (9.4% vs 27.4%, P < 0.05).


CONCLUSIONS
Iron supplementation for at least 2 weeks before colorectal cancer surgery increases Hb and Ht values in anemic patients, and reduces the need for intraoperative transfusion.
Okuyama
Masaki
M
Department of Surgery, Toyonaka Municipal Hospital, 4-14-1 Shibahara-cho, Toyonaka, Osaka 560-8565, Japan.
Ikeda
Kimimasa
K
Shibata
Takashi
T
Tsukahara
Yasuo
Y
Kitada
Masashi
M
Shimano
Takashi
T
D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000517:prevention & control; D001804:Blood Transfusion, Autologous / Q000379:methods / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D003107:Colorectal Surgery / Q000379:methods*; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D058085:Iron Compounds / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011300:Preoperative Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D058085:Iron Compounds