Park Jangho, Park Sang-Jae, Han Sung-Sik, Park Hyeong Min, Yu Jihye, Park Boram, Kim Young-Woo, Kim Sun-Whe
Department of General Surgery, Osan Hankook Hospital, Osan, Korea.
Center for Liver and Pancreatobiliary Cancer, National Cancer Center, Goyang, Korea.
Ann Surg Treat Res. 2023 Aug;105(2):82-90. doi: 10.4174/astr.2023.105.2.82. Epub 2023 Aug 1.
Perioperative transfusion is reported to be an independent risk factor not only for postoperative complications but also for early recurrence of periampullary carcinoma after pancreaticoduodenectomy (PD). The purpose of this study was to evaluate the safety and efficacy of ferric carboxymaltose (FCM) in reducing the need for perioperative transfusion in iron deficiency anemia patients scheduled for PD.
Twenty-two male patients (hemoglobin [Hb] 7 to <13 g/dL) and 18 female patients (Hb 7 to <12 g/dL) were enrolled in the study group and administered FCM 1-3 weeks before PD. The perioperative transfusion rate was the primary endpoint; morbidity, length of postoperative hospital stay, change in hematological parameters after FCM injection, and adverse effects of FCM were also investigated.
The perioperative transfusion rate of the study group was 22.5% (9 of 40). Hb level was significantly higher on the day of the operation compared to baseline (P < 0.001). Levels of Hb, transferrin saturation, and ferritin were higher at the follow-up compared to baseline (P = 0.008, P = 0.033, and P < 0.001, respectively).
FCM administration was associated with a reduced need for perioperative transfusion and can safely stabilize hematological parameters.
据报道，围手术期输血不仅是术后并发症的独立危险因素，也是胰十二指肠切除术（PD）后壶腹周围癌早期复发的独立危险因素。本研究的目的是评估羧基麦芽糖铁（FCM）在减少计划接受PD的缺铁性贫血患者围手术期输血需求方面的安全性和有效性。
22名男性患者（血红蛋白[Hb]7至<13g/dL）和18名女性患者（Hb7至<12g/dL）被纳入研究组，并在PD前1-3周给予FCM。围手术期输血率是主要终点；还调查了发病率、术后住院时间、注射FCM后血液学参数的变化以及FCM的不良反应。
研究组的围手术期输血率为22.5%（40例中的9例）。与基线相比，手术当天的Hb水平显著更高（P<0.001）。随访时的Hb、转铁蛋白饱和度和铁蛋白水平高于基线（分别为P=0.008、P=0.033和P<0.001）。
给予FCM可减少围手术期输血需求，并能安全地稳定血液学参数。
