Objectives:
Iron deficiency anemia is quite common due to impaired iron metabolism and increased blood losses inherent in colorectal cancer. The primary objective of this retrospective research; is to investigate the effect of preoperative iron treatment on the incidence of postoperative anemia in colorectal cancer patients whose anemia was detected in the preoperative anesthesia evaluation and who were undergoing to surgery shortly after intravenous iron treatment.
Materials and Methods:
Data of 40 patients who underwent colorectal cancer surgery between January 1 and August 31, 2023 were included in the study. Demographic characteristics of the patients, preoperative hemoglobin and ferritin levels, administered intravenous iron dose, amount of intraoperative bleeding, and hemoglobin levels measured in the early postoperative period, at discharge, and at the 1st and 3rd months after discharge were recorded retrospectively. Numerical variables were presented as mean ± SD, and categorical variables were presented as number and Data were analyzed with Student’s t-test and Mann-Whitney U test. Pearson’s r and Spearman’s rho test were used for correlation analysis. Alpha error level was accepted as 5% for statistical significance.
Results:
Preoperative hemoglobin and ferritin levels were 11.9 g/dL and 42.9 ng/mL, respectively. Preoperative anemia prevalence was found to be 80%. When the patients’ postoperative and discharge hemoglobin levels were compared with their preoperative hemoglobin levels, about an average of 1 and 1.8 g/dL decrease was detected, respectively. The incidence of postoperative anemia was found to be 54.5%. It was observed that there was a positive correlation between postoperative hemoglobin level and intravenous iron dose. Pre - Postoperative hemoglobin difference showed positive correlation with ClassIntra scores, Clavien-Dindo scores and the amount of fluid administered intraoperatively. It was observed that patients who were found to be anemic in the third month needed more erythrocyte suspension throughout their hospitalization.
Conclusion:
Anemia should be treated at any stage of the perioperative period in colorectal cancer surgery patients. It is necessary to investigate the multifactorial etiology and pathophysiology underlying anemia for each patient.
Keywords: Anemia, Enhanced Recovery After Surgery, Colorectal Cancer
