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News

Blood transfusions increase ileoanal pouch complications

Preoperative anemia is a risk for perioperative transfusion, which increases complications after ileal pouch-anal anastomosis, reports the latest International Journal of Colorectal Diseases.

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Dr Anthony Senagore and colleagues from Ohio assessed the use of perioperative allogeneic blood transfusion after ileal pouch-anal anastomosis.

The team evaluated risk factors associated with the use of the transfusions and the effect on infectious complications after ileal pouch-anal anastomosis.

The investigators included 1202 patients who had ileal pouch-anal anastomosis with ileostomy.

The investigative team divided the patients into 2 groups.

Group 1 included 240 transfused patients, and Group 2 had 962 nontransfused patients.

Data was gathered on age, gender, preoperative anemia, operative blood loss, and transfusion volume.

Anastomotic separation was higher in the transfused group
International Journal of Colorectal Diseases

The team also collected data on incidence of postoperative infectious or anastomotic complications, and length of stay.

The investigators noted that patient age, sex, and preoperative steroid use were similar in both groups.

The team found that significantly more patients with transfusions were anemic preoperatively.

The preoperative hemoglobin level was significantly lower in the transfused group.

The investigators observed that transfusion was required more frequently in anemic patients.

The overall infection rate was significantly higher in the transfused group.

The investigators identified that anastomotic separation, and fistula formation percentage was significantly higher in the transfused group.

Pelvic sepsis also occurred more frequent with transfusion.

The team found that the incidence of any infectious complication at any site was higher in anemic patients irrespective of transfusion status.

Transfusion was the only significant independent risk factor for postoperative infections.

The investigators determined that length of stay was adversely affected by an infectious complication.

Dr Senagore's team concludes, “Preoperative anemia is a risk factor for perioperative transfusion with an increase in postoperative infectious complications and anastomotic complications after ileal pouch-anal anastomosis.”

“Strategies to correct preoperative anemia, refine indications for transfusion, and define the use of blood salvage techniques may be helpful in decreasing this risk.”

Int J Colorect Dis 2006: 21(8): 807-13
11 October 2006

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