The Effect of the Intraoperative Blood Loss and Intraoperative Blood Transfusion on the Short-Term Outcomes and Prognosis of Colorectal Cancer: A Propensity Score Matching Analysis

Abstract

PurposeThe purpose of the current study was to analyze the effect of intraoperative blood loss (IBL) and intraoperative blood transfusion (IBT) on the short-term outcomes and prognosis for patients who underwent primary colorectal cancer (CRC) surgery.MethodsWe retrospectively collected the patients' information from the database of a teaching hospital from January 2011 to January 2020. IBL and IBT were collected and analyzed, and the propensity score matching (PSM) analysis was performed.ResultsA total of 4,250 patients with CRC were included in this study. There were 1,911 patients in the larger IBL group and 2,339 patients in the smaller IBL group. As for IBT, there were 82 patients in the IBT group and 4,168 patients in the non-IBT group. After 1:1 ratio PSM, there were 82 patients in the IBT group and 82 patients in the non-IBT group. The larger IBL group had longer operation time (p = 0.000 < 0.01), longer post-operative hospital stay (p = 0.000 < 0.01), smaller retrieved lymph nodes (p = 0.000 < 0.01), and higher overall complication (p = 0.000 < 0.01) than the smaller IBL group. The IBT group had longer operation time (p = 0.000 < 0.01), longer hospital stay (p = 0.016 < 0.05), and higher overall complications (p = 0.013 < 0.05) compared with the non-IBT group in terms of short-term outcomes. Larger IBL (p = 0.000, HR = 1.352, 95% CI = 1.142–1.601) and IBT (p = 0.044, HR = 1.487, 95% CI = 1.011–2.188) were independent predictive factors of overall survival (OS). Larger IBL (p = 0.000, HR = 1.338, 95% CI = 1.150–1.558) was an independent predictor of disease-free survival (DFS); however, IBT (p = 0.179, HR = 1.300, 95% CI = 0.886–1.908) was not an independent predictor of DFS.ConclusionBased on the short-term outcomes and prognosis of IBL and IBT, surgeons should be cautious during the operation and more careful and proficient surgical skills are required for surgeons.

Association of perioperative allogeneic blood transfusions and long-term outcomes following radical surgery for gastric and colorectal cancers: systematic review and meta-analysis of propensity-adjusted observational studies

“…The remaining four studies 21 , 24–26 did not report which types of blood products were transfused. Of the 12 included studies, six studies originated from Asia 16–19 , 25 , 27 , five from Europe 20–23 , 26 , and one from the USA 24 . All studies except one 24 were performed at a single centre.…”

Streamlining Robotic-Assisted Abdominoperineal Resection

“…Intraoperative blood loss was also within an acceptable range and was even lower (80.5 ml) in the last two cases. Previous studies have shown that surgical pro ciency can affect intraoperative blood loss, which in turn in uences postoperative morbidity and recovery [18,19].…”

Effect of intraoperative blood loss on postoperative complications and prognosis of patients with colorectal cancer: A meta‑analysis

“…The incidence rate of CRC is higher in the elderly ( 27 , 28 ). Advanced age is an important risk factor for postoperative mortality and the elderly had poor performance status, recovery ability and comorbid diseases.…”