Abstracts
2001 Digestive Disease Week

# 2437 Perioperative Blood Transfusions: A Prognostic Factor After Surgical Resection of Esophageal Adenocarcinoma
Marcus Feith, Hubert J. Stein, J. Ruediger Siewert, Munich, Germany

Objectives: Esophagectomy remains the treatment of choice for resectable esophageal adenocarcinoma. The number of perioperative blood transfusions has been correlated with poor prognosis in a number of gastro-intestinal malignancies. The prognostic effect of perioperative blood transfusions in patients who have esophagectomy for esophageal adenocarcinoma has so far not evaluated.

Methods: We investigated in 131 consecutive patients with an adenocarcinoma of the distal esophagus who had esophagectomy with complete macroscopic and microscopic tumor resection the total amount of intraoperative given packed erythrocytes and the influence on the survival after complete resection. A transthoracic or transmediastinal esophagectomy with a two-field lymphadenectomy was the performed procedure in these patients.

Results: Of the 131 patients 74 (56.4%) received a total of 209 units packed erythrocyts during and immediately after the resection of the esophageal adenocarcinoma (range 0-10; mean 2). There was no statistical difference in the amount of transfused units packed erythrocyts between the two surgical procedures. No correlations to the tumor stadium, age or sex of the patients could be found. In the Kaplan-Meier survival analysis a significant difference between the patients with no blood transfusion, smaller than 4 units and 4 or more units of packed erythrocytes was found (p<0.02).

Conclusion: In patients who had esophagectomy for adenocarcinoma of the distal esophagus perioperative transfusion of packed erythrocytes is associated with a significant prognostic impact. Patients without a blood transfusion had a mentionly better survival. This supports the concept of safe surgical techniques in the treatment of adenocarcinoma of the distal esophagus.