Yasuo Tsukahara

Preoperative Iron Supplementation and Intraoperative Transfusion During Colorectal Cancer Surgery

PurposeTo investigative whether giving an iron preparation to anemic patients before colorectal cancer surgery improves their anemia and reduces the need for intraoperative blood transfusion.MethodsAmong 569 patients who underwent colorectal cancer surgery between 1998 and 2003, we studied 32 anemic patients who received iron supplementation for at least 2 weeks preoperatively (group A) and 84 anemic patients who did not (group B). Anemia was defined as a hemoglobin (Hb) level at first presentation of ≤10.0 g/dl. Hemoglobin and hematocrit (Ht) levels were measured at first presentation, then immediately before and after surgery. We also calculated intraoperative blood loss and compared intraoperative transfusion rates.ResultsThere were no significatnt differences between groups A and B in age, sex, surgical technique, tumor stage, and operating time. Their Hb and Ht values were similar at first presentation, but significantly different immediately before surgery (both P < 0.0001). There were no significant differences in intraoperative blood loss between the groups, but significantly fewer patients in group A needed an intraoperative blood transfusion (9.4% vs 27.4%, P < 0.05).ConclusionIron supplementation for at least 2 weeks before colorectal cancer surgery increases Hb and Ht values in anemic patients, and reduces the need for intraoperative transfusion.

Peliosis of the spleen with intraperitoneal hemorrhage.

We encountered a patient with steroidrelated peliosis of the spleen, a rare disease characterized by multiple blood-filled cavities in the splenic parenchyma, with spontaneous intraperitoneal hemorrhage. The ultrasonographic, computed tomographic, and angiographic images were compared with pathologic findings of the material obtained surgically.