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Degree of blood loss during surgery for rectal cancer: a population-based epidemiologic study of surgical complications and survival
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
2014 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 16, no 9, 696-702 p.Article in journal (Refereed) Published
Abstract [en]

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) as a result of adhesions or tumour recurrence, and reduces overall survival. Method Data were retrieved from the Uppsala/Orebro Regional Rectal Cancer Registry for all patients undergoing radical resection for rectal cancer during 1997-2003 (n = 1843) and were 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 Ninety-four (5.1%) patients underwent surgery for SBO > 30 days after the index operation: 82 for adhesions and 12 for tumour recurrence. The volume of blood lost did not influence the risk of surgery for SBO as a result of adhesions, but blood loss above the median (>= 800 ml) increased the risk for surgery for SBO caused by tumour recurrence (hazard ratio = 10.52; 95% CI: 1.36-81.51). Increased blood loss increased the risk of surgical complications (OR = 1.78; 95% CI: 1.35-2.35 with blood loss of >= 450 ml) 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.

Place, publisher, year, edition, pages
2014. Vol. 16, no 9, 696-702 p.
Keyword [en]
Rectal cancer, surgery, blood loss, complications, small bowel obstruction, survival
National Category
Gastroenterology and Hepatology Surgery
URN: urn:nbn:se:uu:diva-231987DOI: 10.1111/codi.12630ISI: 000340496100013OAI: oai:DiVA.org:uu-231987DiVA: diva2:747016
Available from: 2014-09-15 Created: 2014-09-12 Last updated: 2014-09-15Bibliographically approved

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