Degree of blood loss during surgery for rectal cancer: a population-based epidemiologic study of surgical complications and survival
2014 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 16, no 9, 696-702 p.Article in journal (Refereed) Published
AIM: the hypothesis tested in this study was that major blood loss during surgery for rectal cancer increases the risk for surgical complications and for small bowel obstruction (SBO) due to adhesions or tumour recurrence and reduces overall survival.
METHOD: data were retrieved from the Uppsala/Örebro Regional Rectal Cancer Registry for all patients undergoing radical resection for rectal cancer 1997-2003 (n=1,843) and matched against the Swedish National Patient Registry regarding surgery and admission for SBO. These patient records were scrutinized to determine the etiology of surgery for SBO. The registry was scrutinized for blood loss and other surgical complications associated with surgery. Uni- and multivariate Cox analysis and logistic regression were used.
RESULTS: 94 (5.1%) patients underwent surgery for SBO >30 days after the index operation. Of these 82 were caused by adhesions and 12 by tumour recurrence. The volume of blood lost did not influence the risk of surgery for SBO due to adhesions, but blood loss above the median (>800 ml) increased the risk for surgery for SBO caused by tumour recurrence (HR 10.52; 95% CI 1.36-81.51). Increased blood loss increased the risk of surgical complications (OR 2,09; 95% CI 1.60-2.75 with blood loss of 450 ml or more) but did not reduce overall survival. Irradiation before surgery increased blood loss, complications and admission for SBO.
CONCLUSION: major blood loss during surgery for rectal cancer increases the risk of later surgery for SBO caused by tumour recurrence and surgical complications, but overall survival is not affected. This article is protected by copyright. All rights reserved.
Place, publisher, year, edition, pages
2014. Vol. 16, no 9, 696-702 p.
IdentifiersURN: urn:nbn:se:umu:diva-91711DOI: 10.1111/codi.12630ISI: 000340496100013PubMedID: 24720780OAI: oai:DiVA.org:umu-91711DiVA: diva2:737818