Key result
A smaller intraoperative blood loss was associated with a significantly better overall survival (HR 1.45) and disease-free survival (HR 1.76) compared with a larger blood loss in patients with colorectal cancer.
Why the study?
The study was conducted to evaluate whether the amount of intraoperative blood loss affects complications and prognosis in patients with colorectal cancer.
Does smaller intraoperative blood loss improve overall survival and reduce postoperative complications in patients with colorectal cancer?
Meta-Analysis (n=10,540)
Does smaller intraoperative blood loss improve overall survival and reduce postoperative complications in patients with colorectal cancer?
Hazard Ratio: 1.45 (95% CI 1.17–1.8)
p-value: p=0.0007
Smaller intraoperative blood loss during colorectal cancer surgery is associated with improved overall and disease-free survival and fewer postoperative complications.
Greater IBL was associated with worse OS/DFS and complications in CRC; supports minimizing blood loss but leaves open causal confirmation.
The purpose of the present study was to evaluate whether the amount of intraoperative blood loss (IBL) affects the complications and prognosis of patients with colorectal cancer (CRC). The PubMed, EMBASE and the Cochrane Library databases were used to search for eligible studies from inception to November 30, 2020. Hazard ratios (HRs) and 95% confidence intervals (Cls) were pooled up. The overall survival (OS) and disease-free survival (DFS) were compared between the larger IBL group and the smaller IBL group. The present study was performed with RevMan 5.3 (The Cochrane Collaboration). A total of seven studies involving 1,540 patients with CRC were included in the present study. The smaller IBL group had a higher rate of OS (HR=1.45, 95% CI=1.17 to 1.8, P=0.0007) and a higher rate of DFS (HR=1.76, 95% CI=1.40 to 2.21, P<0.00001). Furthermore, the larger IBL group had a higher rate of postoperative complications than the smaller IBL group (odds ratio=2.06, 95% CI=1.72 to 2.15, P<0.00001). In conclusion, a smaller IBL was associated with better OS and DFS, and a lower risk of postoperative complications compared with a larger IBL in patients with CRC, suggesting that surgeons should pay more attention during perioperative management and surgical operation to reduce IBL.
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Li et al. (2023) conducted a meta-analysis in Colorectal cancer (n=10,540). Smaller intraoperative blood loss vs. Larger intraoperative blood loss was evaluated on Overall survival (OS) (HR 1.45, 95% CI 1.17 to 1.80, p=0.0007). A smaller intraoperative blood loss was associated with a significantly better overall survival (HR 1.45) and disease-free survival (HR 1.76) compared with a larger blood loss in patients with colorectal cancer.
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