Gastric cancer surgery: clinical outcomes and prognosis are influenced by perioperative blood transfusions View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-18

AUTHORS

Marica Grasso, Giulia Pacella, Nicola Sangiuliano, Maurizio De Palma, Alessandro Puzziello

ABSTRACT

Gastric cancer in patients is often associated with bleeding; when it occurs, especially in the presence of an anemia, a transfusion is necessary to avoid further deterioration of the patient's clinical state. The aim of this study was to evaluate the relationship between the administration of peri-operative transfusions due to the anemia or the clinical status and the post-operative clinical outcomes. 188 patients diagnosed with of gastric cancer were recruited at Surgery 2 of the Department of General and Specialist Surgery of the Tertiary Care Hospital "A. Cardarelli" of Naples. All patients had a total or a subtotal gastrectomy accompanied by D2 lymphectomy for gastric cancer. The clinical data most frequently associated with blood transfusion is the appearance of a post-operative infection (OR 2.26, 95% CI 0.87-5.79, P = 0.061). If the administration time of transfusion is considered, the clinical outcomes are different: preoperative transfusions showed a higher incidence of infections (OR 2.26, 95% CI 0.87-5.79, P = 0.061) and acute renal failure (OR 2.82, 95% CI 0.70-10.78, P = 0.078); patients who received intra or post-operative transfusions showed a prolonged hospitalization (OR 8.66, 95% CI 1.73-83.00, P = 0.002). The administration of blood products in the perioperative period is correlated in a statistically significant manner to the incidence of infections, acute renal failure and prolonged hospitalization; therefore, transfusions should be avoided unless clinically necessary and in particular intraoperative transfusions should be avoided because the immunomodulation effect linked to surgical stress may be enhanced hence worsening the prognosis. More... »

PAGES

1-5

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s13304-019-00622-7

DOI

http://dx.doi.org/10.1007/s13304-019-00622-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111511414

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30659478


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