Impact of Preoperative Anaemia on Postoperative Outcomes Following Curative Surgery for Stage I–III Colorectal Cancer: A Retrospective Cohort Study
Main Article Content
Keywords
Colorectal cancer, Preoperative Anaemia, Blood Transfusion, Postoperative Complications, Mortality, Recurrence.
Abstract
Background
Preoperative anaemia (POA) is frequently encountered in patients with colorectal cancer (CRC) and has been associated with adverse surgical outcomes. However, evidence regarding its impact on long-term postoperative complications in the Indian population is limited. This study evaluated the association between POA and postoperative morbidity, mortality, and long-term outcomes in patients undergoing curative surgery for Stage I–III CRC.
Materials and Methods
A retrospective cohort study was conducted on 150 patients with histopathologically confirmed Stage I–III CRC who underwent curative surgical resection at Government General Hospital, Rangaraya Medical College, Kakinada, India, between January 2017 and December 2019. Median follow-up was 54 months (ranging from 42-66 months). Patients were categorized as anaemic (n=76) or non-anaemic (n=74) according to preoperative haemoglobin levels. Anaemic patients were further classified as having mild-to-moderate (n=22) or severe anaemia (n=54). Postoperative mortality, tumour recurrence, small bowel obstruction, abdominal wall defects, and perioperative blood transfusion were compared using the Chi-square test or Fisher's exact test, with P<0.05 considered statistically significant.
Results
POA was present in 76 (50.7%) patients. Baseline age and gender distributions were comparable between the anaemic and non-anaemic groups, although severe anaemia was more prevalent in males (P=0.016). Compared with non-anaemic patients, anaemic patients had significantly higher rates of postoperative mortality (19.7% vs. 4.1%; P=0.003), tumour recurrence (34.2% vs. 5.4%; P<0.0001), small bowel obstruction (21.1% vs. 2.7%; P=0.0005), abdominal wall defects (32.9% vs. 2.7%; P<0.0001), and perioperative blood transfusion (77.6% vs. 5.4%; P<0.0001). Within the anaemic group, severe anaemia was significantly associated with abdominal wall defects (P=0.022) and blood transfusion requirements (P<0.0001), whereas differences in mortality, tumour recurrence, and small bowel obstruction were not statistically significant.
Conclusion
POA is associated with significantly poorer postoperative outcomes following curative surgery for Stage I–III CRC. Routine preoperative screening and optimisation of anaemia may reduce postoperative morbidity and transfusion requirements, supporting its incorporation into perioperative patient blood management strategies.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Salapu Ramesh Babu
Postgraduate Resident, Department of General Surgery, Rangaraya Medical College, Kakinada, Andhra Pradesh
P Naresh Kumar MS
Professor, Department of General Surgery, Rangaraya Medical College, Kakinada, Andhra Pradesh.
