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

Ghinea, Ronen; Greenberg, Ron; White, Ian; Sacham-Shmueli, E.; Mahagna, Hussein; Avital, Shmuel

doi:10.1007/s10151-013-1014-y

Cited by 24 publications

(16 citation statements)

References 27 publications

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“…There is a marked difference in 30‐day mortality between completed laparoscopic surgery and conversion which can be accounted for by intra‐operative complications necessitating conversion to an open procedure. Perioperative blood transfusion appears to be more frequently required after conversion in this analysis, and there is some evidence that this may increase the risk of recurrence . The inflammatory response provoked by more extensive surgical resection and postoperative complications in conversion patients is also likely to contribute to an adverse outcome.…”

Section: Discussionmentioning

confidence: 84%

A meta‐analysis to determine the oncological implications of conversion in laparoscopic colorectal cancer surgery

et al. 2015

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Section: Discussionmentioning

confidence: 84%

A meta‐analysis to determine the oncological implications of conversion in laparoscopic colorectal cancer surgery

et al. 2015

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“…Data on OS were from 24 articles [1–4, 8, 9, 11, 13, 14, 16, 17, 19, 21, 22, 24, 28–30, 32–36, 38]. The random-effects model showed that transfusion could decrease OS significantly (HR, 0.33; 95% CI, 0.24 to 0.41; I 2 = 61.9%; P < 0.0001; Fig.…”

Section: Resultsmentioning

confidence: 99%

Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis

Pang

Liu

2019

World J Surg Onc

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BackgroundPerioperative transfusion can reduce the survival rate in colorectal cancer patients. The effects of transfusion on the short- and long-term prognoses are becoming intriguing.ObjectiveThis systematic review and meta-analysis aimed to define the effects of perioperative transfusion on the short- and long-term prognoses of colorectal cancer surgery.ResultsThirty-six clinical observational studies, with a total of 174,036 patients, were included. Perioperative transfusion decreased overall survival (OS) (hazard ratio (HR), 0.33; 95% confidence interval (CI), 0.24 to 0.41; P < 0.0001) and cancer-specific survival (CSS) (HR, 0.34; 95% CI, 0.21 to 0.47; P < 0.0001), but had no effect on disease-free survival (DFS) (HR, 0.17; 95% CI, − 0.12 to 0.47; P = 0.248). Transfusion could increase postoperative infectious complications (RR, 1.89, 95% CI, 1.56 to 2.28; P < 0.0001), pulmonary complications (RR, 2.01; 95% CI, 1.54 to 2.63; P < 0.0001), cardiac complications (RR, 2.20; 95% CI, 1.75 to 2.76; P < 0.0001), anastomotic complications (RR, 1.51; 95% CI, 1.29 to 1.79; P < 0.0001), reoperation(RR, 2.88; 95% CI, 2.05 to 4.05; P < 0.0001), and general complications (RR, 1.86; 95% CI, 1.66 to 2.07; P < 0.0001).ConclusionPerioperative transfusion causes a dramatically negative effect on long-term prognosis and increases short-term complications after colorectal cancer surgery.

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“…However, not all reports have come to the same conclusion [9] and considerable controversy persists regarding cause and effect. In this context, relationships between the need for blood transfusions and other confounders that may contribute to increased risk of adverse outcomes may exist [9]. …”

Section: Introductionmentioning

confidence: 99%

Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes

Danninger

Rasul

Poeran

et al. 2014

The Scientific World Journal

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Background. Various studies have raised concern of worse outcomes in patients receiving blood transfusions perioperatively compared to those who do not. In this study we attempted to determine the proportion of perioperative complications in the orthopedic population attributable to the use of a blood transfusion. Methods. Data from 400 hospitals in the United States were used to identify patients undergoing total hip or knee arthroplasty (THA and TKA) from 2006 to 2010. Patient and health care demographics, as well as comorbidities and perioperative outcomes were compared. Multivariable logistic regression models were fitted to determine associations between transfusion, age, and comorbidities and various perioperative outcomes. Population attributable fraction (PAF) was determined to measure the proportion of outcome attributable to transfusion and other risk factors. Results. Of 530,089 patients, 18.93% received a blood transfusion during their hospitalization. Patients requiring blood transfusion were significantly older and showed a higher comorbidity burden. In addition, these patients had significantly higher rates of major complications and a longer length of hospitalization. The logistic regression models showed that transfused patients were more likely to have adverse health outcomes than nontransfused patients. However, patients who were older or had preexisting diseases carried a higher risk than use of a transfusion for these outcomes. The need for a blood transfusion explained 9.51% (95% CI 9.12–9.90) of all major complications. Conclusions. Advanced age and high comorbidity may be responsible for a higher proportion of adverse outcomes in THA and TKA patients than blood transfusions.

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

Abstract: Perioperative blood transfusion is associated with decreased long-term survival in patients undergoing laparoscopic resection for colorectal cancer. However, this association apparently reflects the poorer medical condition of patients requiring surgery and not a causative relationship.

Cited by 24 publications

References 27 publications

A meta‐analysis to determine the oncological implications of conversion in laparoscopic colorectal cancer surgery

A meta‐analysis to determine the oncological implications of conversion in laparoscopic colorectal cancer surgery

Perioperative transfusion and the prognosis of colorectal cancer surgery: a systematic review and meta-analysis

Blood Transfusions in Total Hip and Knee Arthroplasty: An Analysis of Outcomes

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