Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?

Background While perioperative red blood cell transfusion has been widely associated with poor surgical outcomes, few studies have focused specifically on the preoperative transfusional risk–benefit ratio. The aim of the present study was to evaluate the effects of preoperative red blood cell transf...

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Main Authors: Nicolò Tamini, Giuseppe Deghi, Luca Gianotti, Marco Braga, Luca Nespoli
Format: Article
Language:English
Published: Taylor & Francis Group 2021-08-01
Series:Journal of Investigative Surgery
Subjects:
Online Access:http://dx.doi.org/10.1080/08941939.2020.1731634
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author Nicolò Tamini
Giuseppe Deghi
Luca Gianotti
Marco Braga
Luca Nespoli
author_facet Nicolò Tamini
Giuseppe Deghi
Luca Gianotti
Marco Braga
Luca Nespoli
author_sort Nicolò Tamini
collection DOAJ
description Background While perioperative red blood cell transfusion has been widely associated with poor surgical outcomes, few studies have focused specifically on the preoperative transfusional risk–benefit ratio. The aim of the present study was to evaluate the effects of preoperative red blood cell transfusion on short-term surgical outcomes in a cohort of anemic colon cancer patients. Methods Moderate and severe anemic patients undergoing colectomy for cancer were divided into two groups based upon the receipt of preoperative transfusion and compared in terms of short-term outcomes. Results A total of 271 patients with moderate or severe anemia were identified, 93 (34.3%) of whom were preoperatively transfused with a median of two units of packed red blood cells per patient (interquartile range: 2–4 units). The overall morbidity rate did not differ significantly between the two groups (35.5% vs. 36.2%; p = 0.63), while an increased incidence of major morbidity (Clavien–Dindo grade > 3a) observed in transfused patients [14% vs. 6.2% respectively; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.06–5.75; p = 0.03]. The increase in major morbidity was confirmed by multivariate analysis, adjusted for potential confounders (OR: 3.45; 95% CI: 1.32–9.04; p = 0.01). Conclusions Preoperative blood transfusion is associated with severe postoperative complications following colectomy in moderate and severe anemic cancer patients. Further studies are needed to establish an optimal preoperative transfusional cutoff value to optimize postoperative outcomes and balance clinical costs.
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spelling doaj.art-8e62701f6eb94ec6a4ec93485e3f82d62023-09-15T10:07:32ZengTaylor & Francis GroupJournal of Investigative Surgery0894-19391521-05532021-08-0134997497810.1080/08941939.2020.17316341731634Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?Nicolò Tamini0Giuseppe Deghi1Luca Gianotti2Marco Braga3Luca Nespoli4Asst-Monza, Ospedale San GerardoAsst-Monza, Ospedale San GerardoAsst-Monza, Ospedale San GerardoAsst-Monza, Ospedale San GerardoAsst-Monza, Ospedale San GerardoBackground While perioperative red blood cell transfusion has been widely associated with poor surgical outcomes, few studies have focused specifically on the preoperative transfusional risk–benefit ratio. The aim of the present study was to evaluate the effects of preoperative red blood cell transfusion on short-term surgical outcomes in a cohort of anemic colon cancer patients. Methods Moderate and severe anemic patients undergoing colectomy for cancer were divided into two groups based upon the receipt of preoperative transfusion and compared in terms of short-term outcomes. Results A total of 271 patients with moderate or severe anemia were identified, 93 (34.3%) of whom were preoperatively transfused with a median of two units of packed red blood cells per patient (interquartile range: 2–4 units). The overall morbidity rate did not differ significantly between the two groups (35.5% vs. 36.2%; p = 0.63), while an increased incidence of major morbidity (Clavien–Dindo grade > 3a) observed in transfused patients [14% vs. 6.2% respectively; odds ratio (OR): 2.47, 95% confidence interval (CI): 1.06–5.75; p = 0.03]. The increase in major morbidity was confirmed by multivariate analysis, adjusted for potential confounders (OR: 3.45; 95% CI: 1.32–9.04; p = 0.01). Conclusions Preoperative blood transfusion is associated with severe postoperative complications following colectomy in moderate and severe anemic cancer patients. Further studies are needed to establish an optimal preoperative transfusional cutoff value to optimize postoperative outcomes and balance clinical costs.http://dx.doi.org/10.1080/08941939.2020.1731634anemiacolorectalcolon cancerblood transfusioncolorectal surgerypreoperative transfusions
spellingShingle Nicolò Tamini
Giuseppe Deghi
Luca Gianotti
Marco Braga
Luca Nespoli
Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
Journal of Investigative Surgery
anemia
colorectal
colon cancer
blood transfusion
colorectal surgery
preoperative transfusions
title Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
title_full Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
title_fullStr Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
title_full_unstemmed Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
title_short Colon Cancer Surgery: Does Preoperative Blood Transfusion Influence Short-Term Postoperative Outcomes?
title_sort colon cancer surgery does preoperative blood transfusion influence short term postoperative outcomes
topic anemia
colorectal
colon cancer
blood transfusion
colorectal surgery
preoperative transfusions
url http://dx.doi.org/10.1080/08941939.2020.1731634
work_keys_str_mv AT nicolotamini coloncancersurgerydoespreoperativebloodtransfusioninfluenceshorttermpostoperativeoutcomes
AT giuseppedeghi coloncancersurgerydoespreoperativebloodtransfusioninfluenceshorttermpostoperativeoutcomes
AT lucagianotti coloncancersurgerydoespreoperativebloodtransfusioninfluenceshorttermpostoperativeoutcomes
AT marcobraga coloncancersurgerydoespreoperativebloodtransfusioninfluenceshorttermpostoperativeoutcomes
AT lucanespoli coloncancersurgerydoespreoperativebloodtransfusioninfluenceshorttermpostoperativeoutcomes