Anemia correction in patients with gastric cancer during the preoperative period, the short-term results of surgical treatment

Abstract

INTRODUCTION. In the Russian Federation, among all malignant diseases in the male population, gastric cancer ranks the 4th, in women – 5th place, and in terms of mortality in both sexes from malignant diseases – 2nd place. During surgical treatment of patients with gastric cancer, anemia is detected in more than 1/4 of patients, who significantly worsens the prognosis due to postoperative complications. Timely correction of anemia can reduce the risk of complications during surgical treatment and improve the course of the postoperative period.OBJECTIVE is to evaluate the effectiveness of correction of anemia in the preoperative period and the results of radical surgical treatment in patients with gastric cancerMETHODS AND MATERIALS. The article presents the analysis of medical records of 30 patients aged 56–75 years with a diagnosis of gastric cancer complicated by anemia (hemoglobin level < 80 g/l). All patients in the preoperative period for the correction of anemia were prescribed iron (III) hydroxide oligoisomaltose intravenously at the dose of 20 mg/kg 21 days before surgery, due to the detection of iron deficiency in them.RESULTS. The target blood hemoglobin level was more than 95 g/l. In the absence of the desired effect, erythrocyte transfusion was performed. The use of iron preparations made it possible to correct anemia in 14 (46.7 %) patients without resorting to transfusions, in 16 (53.3 %) patients, it was required to additionally transfuse 1 dose of erythrocytes, while earlier in the preoperative anemia was corrected using transfusions of 2–3 doses of erythrocytes. All patients underwent radical surgery with D2 lymph node dissection. Operations were accompanied by blood loss of 201.0±94.4 ml (120–475 ml). It was revealed that radical surgeries for gastric cancer in patients who received anemia correction in the preoperative period are accompanied by a low number of purulent-inflammatory (in 27.3 % of patients) and cardiovascular complications (in 20 % of patients).CONCLUSION. Correction of anemia is a mandatory part of therapy in the preoperative period and allows to perform a full range of radical surgical intervention, improve the safety of surgical treatment and improve the course of the postoperative period.