Between 10% and 30% of patients undergoing colorectal cancer resection receive a blood transfusion after the operation, K. B. Hosie and colleagues, from Derriford Hospital, Plymouth, UK, note.
Adding that observational studies suggest that preoperative use of iron sucrose can reduce blood transfusions after arthroplasty and hysterectomy, they explain that the goal of the current randomized controlled trial was to determine if this benefit also applied to colorectal cancer surgery.
Their study involved 60 patients who were randomized to receive 600 mg iron sucrose or placebo given IV in two divided doses, at least 24 hours apart, 2 weeks before surgery.
The median hemoglobin levels in the iron and placebo groups at recruitment were 13.4 and 13.7 g/dL, respectively. By the time of surgery, neither group had experienced a significant increase in hemoglobin, with a level of roughly 13.8 g/dL in each.
Fewer patients in the iron group than in the placebo group required blood transfusion (5 vs. 2), but the difference was not statistically significant.
When the analysis was confined to the 18 patients who were anemic at recruitment, the researchers still found no differences between the groups in any of the outcomes studied.
The authors believe that preoperative iron may be of some benefit for anemic patients and suggest that perhaps the dose used in the present study was just too low.
Still, they conclude, “This pilot study provided no support for the use of intravenous iron sucrose as a preoperative adjunct to…reduce the likelihood of allogeneic blood transfusion for patients undergoing resectional surgery for colorectal cancer.”
Brit J Surg 2009;96:1122-1128.