Lawday Samuel, Williams Susannah, James Elizabeth, Court Emma L, Carter Fiona, Rushton Francesca, Dampier Cat, O'Malley E J, Barrington M, Bethune Rob, Francis Nader
Centre for Surgical Research, Population Health Science, University of Bristol, Bristol, UK.
Somerset NHS Foundation Trust, Yeovil, UK.
Int J Colorectal Dis. 2025 Jan 15;40(1):14. doi: 10.1007/s00384-024-04794-6.
Optimal management of anaemia following surgery for colorectal cancer remains unclear. Peri-operative anaemia is common in patients undergoing resectional surgery for colorectal cancer. A significant amount of research has been conducted into the management of pre-operative anaemia; however, little work has investigated post-operative anaemia. We intended to investigate the facilitators of and barriers against the standardised correction of post-operative anaemia. These can aid in identifying optimum treatment for patients following surgery for colorectal cancer.
Four focus groups were held with 29 participants from a multidisciplinary panel of healthcare professionals from two different NHS hospital sites in the UK. The discussions were audio recorded and underwent professional transcription. Transcripts were checked against recordings before undergoing thematic analysis using a realist approach.
Four themes were identified. The key barriers to standardised post-operative anaemia correction were a lack of protocoled guidelines or a defined pathway, insufficient education and training, and systemic barriers, such as financial drivers and drug availability. The key facilitator identified was collaboration and communication.
This study has identified several key barriers and thresholds which can be used in future studies to improve the standardised management of post-operative anaemia.
结直肠癌手术后贫血的最佳管理仍不明确。围手术期贫血在接受结直肠癌切除手术的患者中很常见。针对术前贫血的管理已开展了大量研究；然而，关于术后贫血的研究却很少。我们旨在调查术后贫血标准化纠正的促进因素和障碍。这些有助于为结直肠癌手术后的患者确定最佳治疗方案。
与来自英国两个不同国民健康服务（NHS）医院的多学科医疗专业人员小组的29名参与者进行了4次焦点小组讨论。讨论进行了录音并由专业人员转录。在使用现实主义方法进行主题分析之前，对照录音对转录文本进行了核对。
确定了四个主题。术后贫血标准化纠正的主要障碍是缺乏规范化指南或明确的路径、教育和培训不足以及系统性障碍，如经济因素和药物供应情况。确定的主要促进因素是协作与沟通。
本研究确定了几个关键障碍和阈值，可用于未来的研究，以改善术后贫血的标准化管理。
