Members Members Residents Job Board
Join Today Renew Your Membership Make A Donation
2006 Abstracts: Outcomes in bloodless care patients having colonic resection
Back to 2006 Program and Abstracts
Outcomes in bloodless care patients having colonic resection
James Izanec1, Deborah A. Nagle2; 1Gastroenterology, Graduate Hospital , Philadelphia , PA ; 2Surgery, Cooper University Hospital , Camden , NJ

Background: Patients who require abdominal surgery but cannot receive blood products for religious reasons pose unique challenges. Our institution specializes in the medical and surgical care of these patients, specifically the judicious use of erythropoietin and intravenous iron, as well as limiting blood draws. Hemodilution is not used at our institution. We investigated to see how the outcomes in patients undergoing colectomy with bloodless care compared with those receiving traditional care. Methods: A total of 27 bloodless care patients underwent colectomy between 1998 and 2005. We reviewed the charts of these 27 patients along with 43 age matched, procedure-matched controls. Operations preformed included total abdominal colectomy, subtotal colectomy, open hemicolectomy, laparscopic assisted hemicolectomy and proctectomy. Demographics, comorbidities, laboratory tests and outcomes were then recorded and then examined with either a paired t-test or with chi-squared analysis. Results: There was no statistically significant difference in rates of coronary artery disease, hypertension, COPD, CVA, DM, end-stage renal disease, need for emergent surgery, or type of procedures between the two groups. The study group had a lower pre-op hemoglobin, 9.7 ± 2.8 g/dL vs. 11.8 ± 1.8 g/dL (p < .005 compared to control group), and nadir hemoglobin of 8.7 ± 2.4 g/dL vs 9.2 ± 1.8 g/dL (p < .01). The study group was more likely to have received erythropoeitin (85% vs. 9 %, p <.0001). There were no significant differences in age, prothombin time, blood loss during surgery, length of stay, or complication rates between the two groups (Table 1). There were no deaths (0/27)in the perioperative period (21 days from surgery) in the study group; there was one in the control group (1/43, 2%; p = NS). Conclusions: Bloodless care patients who have colorectal surgery have outcomes similar to patients who can accept blood products, despite lower hemoglobin levels and without the use of hemodilution. Our center found no differences in peri-operative mortality or morbidity.
Outcomes in study population and control population

 

Study group (n=27)

Control group (n=43)

p value (x-squared test or paired t-test)

pre-op Hb (g/dL)

9.7 ± 2.8

11.8 ± 1.8

<.005

nadir hemoglobin (g/dL)

8.7 ± 2.4

9.2 ± 1.8

<.05

estimated operative blood loss (mL)

249 ± 249

263 ± 241

NS

use of erythropoietin

23/27

4/43

p <.0001

peri-op mortality

0/26

1/43

NS

MI or CVA

0/26

0/43

NS

LOS (days)

10 ± 11

13 ± 15

NS

units of PRBC transfused/patient

0

2.0±3.5

<.005


Back to 2006 Program and Abstracts


Society for Surgery of the Alimentary Tract

Facebook Twitter YouTube

Email SSAT Email SSAT
500 Cummings Center, Suite 4400, Beverly, MA 01915 500 Cummings Center
Suite 4400
Beverly, MA 01915
+1 978-927-8330 +1 978-927-8330
+1 978-524-0498 +1 978-524-0498
Links
About
Membership
Publications
Newsletters
Annual Meeting
Join SSAT
Job Board
Make a Pledge
Event Calendar
Awards