title: Intravenous iron supplementation may be superior to observation in acute isovolemic anemia after gastrectomy for cancer.
abstract: OBJECTIVE
  To determine whether the application of post-operative intravenous (IV)-iron for acute isovolemic anemia after gastrectomy for cancer may be effective.
  
  
  METHODS
  Among 2078 gastric cancer patients who underwent surgery between February 2007 and August 2009 at the National Cancer Center Korea, 368 patients developed post-operative anemia [hemoglobin-(Hb)-level < 9 g/dL] within the first postoperative week. Patients requiring transfusions were excluded. IV-iron was administered to 63 patients (iron group). Sixty patients were observed without treatment (observation group). The clinical outcomes of the groups were compared concerning clinicopathologic data, morbidity, and changes in Hb levels using Fisher's exact test, Student's t-test and the Z-test.
  
  
  RESULTS
  The initial Hb level was higher in the iron group than in the observation group (7.3 ± 1.0 g/dL vs 8.4 ± 0.5 g/dL, P < 0.001). The slope of the changes in the Hb level was significantly higher in the iron group than in the observation group (0.648 ± 0.054 vs 0.349 ± 0.038, P < 0.001). The Hb level 1 and 3 mo post-operatively increased from 10.7 ± 1.3 to 11.9 ± 1.3 g/dL in the iron group (P = 0.033) and from 10.1 ± 1.0 to 10.8 ± 1.4 g/dL in the observation group (P < 0.001). The postoperative hospital stay was significantly longer in the iron group than in the observation group (10.5 ± 6.8 d vs 7.6 ± 5.5 d, P = 0.011). There were no significant differences in the major and surgical complications between the groups (6.3% vs 13.3%, P = 0.192; 9.5% vs 3.3%, P = 0.164).
  
  
  CONCLUSIONS
  IV-iron supplementation may be an effective treatment for post-operative isovolemic post-gastrectomy anemia and may be a better alternative than observation.
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Hong Man
authors.initials: HM
authors.lastname: Yoon
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Byung Ho
authors.initials: BH
authors.lastname: Nam
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Daniel
authors.initials: D
authors.lastname: Reim
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Bang Wool
authors.initials: BW
authors.lastname: Eom
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Park
authors.affiliation: Hong Man Yoon, Young-Woo Kim, Daniel Reim, Bang Wool Eom, Ji Yeon Park, Keun Won Ryu, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si 410-769, South Korea.
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000740:Anemia / Q000150:complications* / Q000628:therapy*; D016022:Case-Control Studies; D019587:Dietary Supplements; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006454:Hemoglobins / Q000737:chemistry; D006801:Humans; D007501:Iron / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000150:complications* / Q000601:surgery*; D011184:Postoperative Period; D056910:Republic of Korea; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006454:Hemoglobins; D007501:Iron
keywords: Acute isovolemic anemia; Gastrectomy; Gastric cancer; Intravenous iron; Observation