Related Experiment Video
Updated: Jan 12, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Perioperative red blood cell transfusion following high-risk oncologic surgery for tumor resection: a systematic
Xavier Chapalain1, Morgane Zaïna1, Jean-Philippe Metges2
1Department of Anesthesiology and Surgical Intensive Care Unit, Brest University Hospital, Brest, France.
Background/Objectives:
Cancer-related anemia is associated with poorer quality of life and cancer progression. Red blood cell (RBC) transfusion might have an impact on perioperative outcomes after major oncologic surgery. We performed a systematic review and meta-analysis to evaluate whether RBC transfusion exposure (yes/no) and whether RBC transfusion strategies ('liberal' vs. 'restrictive') may impact on postoperative outcomes for patients admitted to an intensive care unit (ICU) following oncologic surgery.
Methods:
We searched Pubmed, Embase and Cochrane Library to identify eligible articles published between 1st January 2000 to 31st December 2023. We included clinical trials and observational studies that evaluated RBC transfusion exposure and all studies that compared 'liberal' vs. 'restrictive' transfusion strategies, in adult critically ill patients admitted to ICU after oncologic surgery.
Results:
Ten observational studies that compared transfused vs. non-transfused patients, and three comparative transfusion strategy studies (two randomized-controlled trials [RCTs] and one non-randomized) were included. In the observational studies, non-transfused patients had a better survival (OR 0.24 [0.06-0.92], p = 0.04; I2 = 78 %), as well as reduced risks of sepsis (OR 0.37 [0.14-0.97], p = 0.04; I2 = 91 %), acute kidney injury (OR 0.37 [0.21-0.65], p = 0.0005; I2 = 83 %) and pneumonia (OR 0.32 [0.19-0.52], p < 0.00001; I2 = 59 %). Hospital length-of-stay was also lower for non-transfused patients: mean difference -4.7 days [-7.13 to -2.26], p = 0.0002 (I2 = 94 %). In the two RCTs, no difference was found between 'liberal' and 'restrictive' transfusion strategies on main outcomes. However, the strength of evidence was 'very low' to 'low' quality for the two RCTs.
Conclusions:
After major oncologic surgery, perioperative anemia requiring transfusion therapy may impact adversely on postoperative outcomes. Our meta-analysis revealed high heterogeneity in observational studies and low strength of evidence in the transfusion strategy RCTs. Further high-quality comparative studies are needed to investigate RBC transfusion in this setting.
More Related Videos
13:37A Mouse Tumor Model of Surgical Stress to Explore the Mechanisms of Postoperative Immunosuppression and Evaluate Novel Perioperative Immunotherapies
Published on: March 12, 2014
12:27Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
02:49Cancer Therapies
However, cancer treatments can pose several challenges, as therapies used to kill cancer cells are generally also toxic to normal cells. Moreover, cancer cells mutate rapidly and can develop resistance to chemical agents or radiation therapy. Besides, all types of cancer cells may not respond to the same therapy. Some cancer cells respond to one...
01:15Blood Transfusion
Blood Transfusion Overview
A blood transfusion is a medical procedure used to replace blood lost due to injury, surgery, or to treat conditions such as anemia or cancer. During a transfusion, donor blood is...