Perioperative blood transfusion in cancer patients undergoing laparoscopic colorectal resection: risk factors and impact on survival

2013 ◽  
Vol 17 (5) ◽  
pp. 549-554 ◽  
Author(s):  
R. Ghinea ◽  
R. Greenberg ◽  
I. White ◽  
E. Sacham-Shmueli ◽  
H. Mahagna ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Colorectal Resection ◽  
Laparoscopic Colorectal Resection ◽  
Impact On Survival ◽  
Perioperative Blood Transfusion

scholarly journals Malnutrition-Related Factors Increased the Risk of Anastomotic Leak for Rectal Cancer Patients Undergoing Surgery

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Hao Xu ◽  
Fanmin Kong
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Nutritional Support ◽  
Perioperative Period ◽  
Tumor Stage ◽  
Rectal Cancer Surgery ◽  
Increased Risk ◽  
Perioperative Blood Transfusion

Objective. To study the possible risk factors and related prediction indexes of anastomotic leakage (AL) in patients with rectal cancer during the perioperative period and to provide effective indexes for predicting whether AL will occur in postoperative patients with rectal cancer and whether early nutritional support is needed. Background. AL after rectal cancer surgery is a common and serious complication. Many of the risk factors for AL have been confirmed. Nevertheless, the evidence of the effect of perioperative malnutrition on AL is still insufficient. This article will make a further study on this point. Methods. We collected perioperative clinical data from 382 patients with rectal cancer who underwent surgery from September 2015 to May 2017. After 1 month of follow-up, relevant risk factor data were collected and analyzed. Results. Data analysis showed that the incidence of AL was 14.65%. In single factor analysis, patients with high score of NRS-2002, high score of PG-SGA, diabetes, perioperative blood transfusion, postoperative diarrhea, later tumor stage, high score of ASA, low postoperative albumin, and rectal cancer patients with tumor close to the anus may led to AL. Multivariate analysis revealed that low postoperative albumin (p=0.044), tumor close to the anus (p=0.004), diabetes (p=0.003), perioperative blood transfusion (p<0.001), diarrhea (p=0.005), later tumor stage, and high score of PG-SGA (p<0.001) were the independent risk factors for postoperative AL. Conclusions. AL in rectal cancer operation is a common postoperative complication. Patients with diabetes or high PG-SGA score or low perioperative albumin will have increased risk factors of AL, which should be paid enough attention in the perioperative period and nutritional support should be provided as soon as possible. Patients who have incomplete intestinal obstruction but can make effective intestinal preparation or who receive neoadjuvant chemotherapy have no increased risk of AL.

Identification of predictive factors for perioperative blood transfusion in colorectal resection patients

2007 ◽  
Vol 22 (12) ◽  
pp. 1493-1497 ◽  
Author(s):  
Justin Kim ◽  
Viken Konyalian ◽  
Richard Huynh ◽  
Raj Mittal ◽  
Michael Stamos ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Predictive Factors ◽  
Colorectal Resection ◽  
Perioperative Blood Transfusion

96: Risk factors for perioperative blood transfusion in patients undergoing hysterectomy for benign disease

2020 ◽  
Vol 222 (3) ◽  
pp. S830-S831
Author(s):  
D. Timmons ◽  
M.M. Grady ◽  
M. Lederer ◽  
A. Wong ◽  
F. Andrade ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Transfusion ◽  
Benign Disease ◽  
Perioperative Blood Transfusion

Risk Factors Analysis of Postoperative Pleural Effusion after Liver Resection

2018 ◽  
Vol 36 (6) ◽  
pp. 514-521 ◽  
Author(s):  
Kuei-Yen Tsai ◽  
Hsin-An Chen ◽  
Wan-Yu Wang ◽  
Ming-Te Huang
Keyword(s):  
Risk Factors ◽  
Pleural Effusion ◽  
Blood Transfusion ◽  
Univariate Analysis ◽  
Pulmonary Complications ◽  
Older Age ◽  
Heavy Smoker ◽  
Chronic Obstructive ◽  
Heavy Smoking ◽  
Perioperative Blood Transfusion

Background: Pulmonary complications remain relatively high in morbidities that arise after liver surgery and are associated with increased length of hospital stay and higher cost. Identification of possible risk factors in this retrospective analysis may help reduce operative morbidity and achieve better outcomes. Methods: In all, 363 consecutive patients underwent elective hepatectomies between July 2008 and November 2013 and these were identified and analyzed retrospectively. Patient demographics and perioperative variables were collected. The main outcome was an analysis of risk factors associated with postoperative pleural effusion (PPE). Results: Of 363 patients receiving hepatectomies, 80 patients (22.0%) developed pulmonary complications. The predominant pulmonary complication in this series is pleural effusion (76 patients, 95%). Univariate analysis found that older age, higher body mass index (BMI), chronic obstructive lung disease, asthma, heart disease, hepatitis C infection, heavy smoking, American Society of Anesthesiology class III and IV, hepatectomy site, combined surgeries, perioperative blood transfusion, and cirrhosis of liver were associated with PPE. Only older age, higher BMI, asthma, heavy smoker, combined gastrointestinal surgeries, and perioperative blood transfusion were identified as independent risk factors in multivariate analysis. Conclusion: This study identifies 6 risk factors for PPE. Identification and management of some of these factors could possibly reduce morbidity and improve short-term surgical outcomes.

scholarly journals Joint effect of pre-operative anemia and perioperative blood transfusion on outcomes of colon-cancer patients undergoing colectomy

2019 ◽  
Vol 8 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Zheng Liu ◽  
Jia-Jun Luo ◽  
Kevin Y Pei ◽  
Sajid A Khan ◽  
Xiao-Xu Wang ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Blood Transfusion ◽  
Cancer Patients ◽  
Death Rate ◽  
Joint Effect ◽  
Severe Anemia ◽  
Joint Effects ◽  
Mild Anemia ◽  
Operative Complications ◽  
Perioperative Blood Transfusion

Abstract Background Both pre-operative anemia and perioperative (intra- and/or post-operative) blood transfusion have been reported to increase post-operative complications in patients with colon cancer undergoing colectomy. However, their joint effect has not been investigated. The purpose of this study was to evaluate the joint effect of pre-operative anemia and perioperative blood transfusion on the post-operative outcome of colon-cancer patients after colectomy. Methods We identified patients from the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database 2006–2016 who underwent colectomy for colon cancer. Multivariate logistic regression analysis was employed to assess the independent and joint effects of anemia and blood transfusion on patient outcomes. Results A total of 35,863 patients—18,936 (52.8%) with left-side colon cancer (LCC) and 16,927 (47.2%) with right-side colon cancer (RCC)—were identified. RCC patients were more likely to have mild anemia (62.7%) and severe anemia (2.9%) than LCC patients (40.2% mild anemia and 1.4% severe anemia). A total of 2,661 (7.4%) of all patients (1,079 [5.7%] with LCC and 1,582 [9.3%] with RCC) received a perioperative blood transfusion. Overall, the occurrence rates of complications were comparable between LCC and RCC patients (odds ratio [OR] = 1.01; 95% confidence interval [CI] = 0.95–1.07; P = 0.750). There were significant joint effects of anemia and transfusion on complications and the 30-day death rate (P for interaction: 0.010). Patients without anemia who received a transfusion had a higher risk of any complications (LCC, OR = 3.51; 95% CI = 2.55–4.85; P &lt; 0.001; RCC, OR = 3.74; 95% CI = 2.50–5.59; P &lt; 0.001), minor complications (LCC, OR = 2.54; 95% CI = 1.63–3.97; P &lt; 0.001; RCC, OR = 2.27; 95% CI = 1.24–4.15; P = 0.008), and major complications (LCC, OR = 5.31; 95% CI = 3.68–7.64; P &lt; 0.001; RCC, OR = 5.64; 95% CI = 3.61–8.79; P &lt; 0.001), and had an increased 30-day death rate (LCC, OR = 6.97; 95% CI = 3.07–15.80; P &lt; 0.001; RCC, OR = 4.91; 95% CI = 1.88–12.85; P = 0.001) than patients without anemia who did not receive a transfusion. Conclusions Pre-operative anemia and perioperative transfusion are associated with an increased risk of post-operative complications and increased death rate in colon-cancer patients undergoing colectomy.

scholarly journals Strategy to Avoid Anastomotic Leakage in Laparoscopic Colorectal Resection Using the Indocyanine Green Fluorescence System

2021 ◽  
Vol 105 (1-3) ◽  
pp. 714-719
Author(s):  
Jun Higashijima ◽  
Toshiaki Yoshimoto ◽  
Shohei Eto ◽  
Hideya Kashihara ◽  
Chie Takasu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Flow ◽  
Indocyanine Green ◽  
Anastomotic Leakage ◽  
Colorectal Resection ◽  
Green Fluorescence ◽  
Laparoscopic Colorectal Resection ◽  
Indocyanine Green Fluorescence ◽  
Diverting Stoma ◽  
Double Stapling

Purpose Anastomotic leakage (AL) in colorectal resections is often caused by insufficient blood flow to the stump. Injecting indocyanine green can help detect blood flow intraoperatively. In this study, we evaluated our original strategy using an indocyanine green fluorescence system to avoid AL. Methods We retrospectively evaluated 79 patients who underwent laparoscopic colorectal resection for colon cancer using a double-stapling technique. Blood flow in oral stumps was evaluated by measuring indocyanine green fluorescence time (FT). We investigated AL cases in detail and analyzed correlations between FT and risk factors for AL. Results Of the 79 patients, 7 (8.9%) developed AL. We divided patients by FTs: &gt;60 seconds, 50 to 60 seconds, and &lt;50 seconds. The AL rates were FT &gt;60 seconds, 60%; FT 50 to 60 seconds, 10.3%; and FT &lt;50 seconds, 2.2%. The AL rate of high-risk cases (with more than 2 risk factors) were calculated and we made our original strategy to avoid AL as the following. Further resection or diverting stomas were needed by the FT &gt;60 seconds group, and by members of the FT 50 to 60 seconds group with ≥3 risk factors. The FT &lt;60 seconds group needed no additional management. Conclusions Patients with delayed FT (&gt;60 seconds, or 50–60 seconds with ≥3 risk factors) may need revision of the anastomosis (diverting stoma or additional resection) to avoid AL. Our original strategy may contribute to reduce AL in colorectal operations.

scholarly journals Development and validation of a nomogram to predict perioperative blood transfusion for gastric cancer surgery

2020 ◽  
Author(s):  
Haoquan Huang ◽  
Zhixiao Han ◽  
Xia Liang ◽  
Zhongqi Liu ◽  
Shi Cheng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Cancer ◽  
Blood Transfusion ◽  
Goodness Of Fit ◽  
Validation Cohort ◽  
Cancer Surgery ◽  
Goodness Of Fit Test ◽  
Gastric Cancer Surgery ◽  
Independent Risk Factors ◽  
Perioperative Blood Transfusion

Abstract Background This study aimed to construct and validate a nomogram composed of preoperative variables to predict perioperative blood transfusion for gastric cancer surgery. Methods 600 gastric cancer patients undergoing gastrectomy between January 2010 and December 2015 were selected as primary cohort. 399 patients from January 2016 to June 2019 were collected as validation cohort. In the primary cohort, univariate and multivariate analyses were performed to identify independent risk factors for blood transfusion. Using Akaike information criterion, selected variables were incorporated to construct a nomogram. Validations of the nomogram were performed in the primary and validation cohort. Discrimination of the nomogram was assessed by the concordance index (C-index) and calibration of the nomogram was assessed by calibration curve and Hosmer–Lemeshow goodness-of-fit test. Results The following independent risk factors for transfusion were identified: Charlson comorbidity index score over 3 (odds ratio (OR) 2.15), tumor location (diffuse vs upper: OR 1.50), pTNM stage (III vs I: OR 3.17), type of gastrectomy (subtotal vs total gastrectomy: OR 0.58), extragastric organ resection (OR 2.03) and preoperative hemoglobin less than 80 g/l (vs over 120 g/l: OR 66.03). C-index was 0.863 and 0.901 in the primary and validation cohort, respectively, indicating good discrimination of the nomogram. Both calibration curves and Hosmer–Lemeshow goodness-of-fit tests (P-value 0.716 and 0.935) demonstrated high agreement between prediction and actual outcome. Conclusion A nomogram composed of preoperative variables to predict blood transfusion for gastric cancer surgery was developed and validated. This nomogram could be used to improve utilization of packed red blood cells.

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