RT Journal Article
T1 Perioperative anemia management in colorectal cancer patients: A pragmatic approach.
A1 Muñoz, Manuel
A1 Gómez-Ramírez, Susana
A1 Martín-Montañez, Elisa
A1 Auerbach, Michael
K1 Colorectal cancer
K1 Anemia
K1 Allogeneic blood transfusion
K1 Intravenous iron
K1 Erythropoiesis stimulating agents
K1 Patient blood management
K1 Neoplasias colorrectales
K1 Infección hospitalaria
K1 Transfusión sanguínea
K1 Tromboembolia venosa
AB Anemia, usually due to iron deficiency, is highly prevalent among patients with colorectal cancer. Inflammatory cytokines lead to iron restricted erythropoiesis further decreasing iron availability and impairing iron utilization. Preoperative anemia predicts for decreased survival. Allogeneic blood transfusion is widely used to correct anemia and is associated with poorer surgical outcomes, increased post-operative nosocomial infections, longer hospital stays, increased rates of cancer recurrence and perioperative venous thromboembolism. Infections are more likely to occur in those with low preoperative serum ferritin level compared to those with normal levels. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management, minimizes or eliminates allogeneic blood transfusion. This includes restrictive transfusion policy, thromboprophylaxis and anemia management to improve outcomes. Normalization of preoperative hemoglobin levels is a World Health Organization recommendation. Iron repletion should be routinely ordered when indicated. Oral iron is poorly tolerated with low adherence based on published evidence. Intravenous iron is safe and effective but is frequently avoided due to misinformation and misinterpretation concerning the incidence and clinical nature of minor infusion reactions. Serious adverse events with intravenous iron are extremely rare. Newer formulations allow complete replacement dosing in 15-60 min markedly facilitating care. Erythropoiesis stimulating agents may improve response rates. A multidisciplinary, multimodal, individualized strategy, collectively termed Patient Blood Management used to minimize or eliminate allogeneic blood transfusion is indicated to improve outcomes.
PB Baishideng Publishing Group Co. Limited
SN 1007-9327
YR 2014
FD 2014-02-28
LK http://hdl.handle.net/10668/1554
UL http://hdl.handle.net/10668/1554
LA en
NO Muñoz M, Gómez-Ramírez S, Martín-Montañez E, Auerbach M. Perioperative anemia management in colorectal cancer patients: A pragmatic approach. World J. Gastroenterol. 2014; 20(8):1972-1985
NO REVIEW;
DS RISalud
RD Apr 18, 2025