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

  • Marica GrassoEmail author
  • Giulia Pacella
  • Nicola Sangiuliano
  • Maurizio De Palma
  • Alessandro Puzziello
Original Article

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.

Keywords

Gastric cancer Blood transfusion Post-operative infection Perioperative transfusion 

Notes

Compliance with ethical standards

Conflict of interest

Authors disclose no conflicts of interest.

Ethical approval

As observational study no ethical approval was requested by our institution.

Research involving human participants and/or animals

As observational study, this article does not contain any studies with human or animal subjects performed by the any of the authors.

Informed consent

Informed consent has been signed by all the participants.

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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  1. 1.Faculty of Medicine, Surgery and DentistryUniversity of SalernoBaronissiItaly
  2. 2.UOC Chirurgia Generale 2, AORN CardarelliNaplesItaly

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