Prevalence of anemia and outcome of restrictive transfusion practice in a cohort undergoing total laparoscopic hysterectomy for benign indications

BACKGROUND: Perioperative anemia is frequently observed in women undergoing gynecological procedures. This research investigated the occurrence of anemia in females undergoing total laparoscopic hysterectomy (TLH) for benign conditions and evaluate outcomes after implementing a conservative transfusion approach. AIMS: This study aimed to examine the occurrence of anemia and assess clinical results under a restrictive transfusion protocol in women receiving TLH for noncancerous reasons. METHODOLOGY: A prospective cohort study was conducted at Teaching Hospital Peradeniya, Sri Lanka, from January 2023 to July 2024. A total of 152 adult women undergoing elective TLH for benign gynecological issues were included in the study. Individuals with blood disorders (excluding anemia), cancer, or re-operations were excluded from the study. Information regarding demographics, comorbidities, hemoglobin (Hb) levels, perioperative details, transfusion requirements, and postoperative results was gathered. STATISTICS: Data were analyzed using SPSS version 22.0. Descriptive statistics and Chi-square tests were used; P < 0.05 was considered significant. RESULTS: Among 152 patients who underwent TLH, 55.26% were found to be anemic, with an average Hb level of 11.36 g/dL. Only six patients needed blood transfusions before surgery. The other anemic patients were treated using a restrictive approach to transfusions. There were no notable differences in postoperative complications, readmission rates, or length of hospital stay between the anemic and nonanemic groups, demonstrating the safety of the restrictive transfusion strategy. CONCLUSIONS: Anemia is common in women undergoing TLH for benign conditions. A restrictive transfusion strategy is safe and does not increase postoperative complications.