Abstract

Background. Evidence on the role of intravenous iron (IVI) supplementation after colorectal cancer (CRC) surgery is rather scant. This study was aimed at assessing the benefit of post-operative IVI administration after elective CRC surgery at our institution.
Materials and methods. This was a single-centre, retrospective observational study including all patients who underwent CRC surgery during 2014. Anaemia was defined as a haemoglobin (Hb) <13 g/dL, regardless of gender. Anaemic patients received 200 mg IVI up to three times a week to cover iron deficiency (IVI group). Those who did not receive IVI were placed on standard care (NIVI group). The primary outcome was the proportion of anaemic patients on post-operative day (POD)1 and POD30. Secondary outcomes included Hb changes from POD1 to POD30, transfusion requirements and complication rates.
Results. Of the 159 patients studied, 139 (87%) presented with anaemia: 47 (34%) of these received post-operative IVI and 92 (66%) did not. Patients in the IVI group had lower POD1 Hb levels compared to those in the NIVI group (p=0.001). On POD30, only 103 had their Hb measured (34 IVI, 69 NIVI). Anaemia was more prevalent and more severe among the patients in the IVI group (p=0.027), despite their greater increment in Hb (2.0±1.5 g/dL vs 1.1±1.2 g/dL; p=0.001). Eleven patients needed post-operative transfusions (7 IVI, 4 NIVI; p=0.044). There were no differences in post-operative complication rates between the groups. No IVI-related adverse events were recorded
Discussion. Compared with standard care, post-operative IVI administration to anaemic patients improved the recovery of Hb levels at POD30, without increasing post-operative complications.

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Authors

María Jesús Laso-Morales - Department of Anaesthesiology, "Parc Taulí" University Hospital, Research and Innovation Institute "Parc Taulí I3PT", Sabadell

Roser Vives - Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, "Parc Taulí" University Hospital, Research and Innovation Institute "Parc Taulí I3PT", Sabadell

Susana Gómez-Ramírez - Internal Medicine, "Virgen de la Victoria" University Hospital, Málaga

Anna Pallisera-Lloveras - Department of Surgery, "Parc Taulí" University Hospital, Research and Innovation Institute "Parc Taulí I3PT", Sabadell, Spain

Caridad Pontes - Department of Pharmacology, Therapeutics and Toxicology, Autonomous University of Barcelona, "Parc Taulí" University Hospital, Research and Innovation Institute "Parc Taulí I3PT", Sabadell

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