Effect of Intravenous Iron Supplementation for Acute Postoperative Anemia in Patients Undergoing Gastrectomy for Gastric Carcinoma: A Pilot Study

Abstract

Several previous studies have concluded that iron supplementation is not beneficial for correcting acute postoperative anemia. However, little data are available about the effect of intravenous (i.v.) iron supplementation for acute postoperative anemia in patients undergoing gastrectomy. Between February 2009 and May 2012, 527 patients underwent gastrectomy for gastric carcinoma. From February 2011, we began i.v. iron supplementation for patients with acute postoperative anemia (hemoglobin (Hb) ≤10 g/dL) at our institute. This study compared the changes of serum Hb up to postoperative 6 months between the patients treated before and after the introduction of i.v. iron supplementation. A total of 142 patients had acute postoperative anemia (Hb ≤10 g/dL). Of these, 68 patients (47.9%) received i.v. iron supplementation. There were no significant differences in age, gender, operation type, tumor stage, and the presence of postoperative chemotherapy between the i.v. iron supplementation and no-supplementation group. Postoperatively, the serum Hb increase over time was significantly better in the i.v. iron supplementation group (repeated measures ANOVA, p = .009). The mean increase of Hb at postoperative 6 months was 3.2 g/dL in the i.v. supplementation group and 2.5 g/dL in the no-supplementation group (p = .029). Multivariate analysis revealed that i.v. iron supplementation was an independent factor of increased serum Hb at postoperative 6 months. Unlike non-gastrointestinal surgery, i.v. iron significantly increased serum Hb in patients developing acute postoperative anemia after gastrectomy. A prospective randomized trial is warranted to confirm the role of i.v. iron supplementation in patients with gastrectomy.