Patient blood management in colorectal cancer patients: a survey among Dutch gastroenterologists, surgeons, and anesthesiologists
2018
INTRODUCTION: There is an increasing awareness to integrate patient
blood management(PBM) within routine surgical care. Limited information about the implementation of PBM in
colorectal cancersurgery is available. This is curious, as preoperative anemia, associated with increased morbidity, is highly prevalent in
colorectal cancerpatients. Present study aimed to assess the current PBM strategies in the Netherlands. METHODS: An online electronic survey was developed and sent to surgeons of the Dutch Taskforce Coloproctology (177 in total). In addition, for each hospital in which surgery for
colorectal cancersurgery is performed (75 in total), the survey was sent to one gastroenterologist and one anesthesiologist. Analyses were performed using descriptive statistics. RESULTS: A total of 192 physicians responded to the survey (response rate 58.7%). In 73 hospitals (97.3%) the survey was conducted by at least one physician. Regarding the management of a mild-moderate preoperative anemia, no clear policy was reported in half of the hospitals (49.3%). In 38.7% of the hospitals, iron status was indicated to be measured during screening for
colorectal cancer. In addition, in only 13.3% of the hospitals, iron status was measured by the anesthesiologist during preoperative assessment. CONCLUSION: The Present study shows a distinct variability in PBM practices in
colorectal cancercare. Strikingly, this variability was not only seen between, but also within Dutch hospitals, demonstrated by often variable responses from physicians from the same institution. As a result, the present study clearly demonstrates the lack of consensus on PBM, resulting in a suboptimal preoperative
blood managementstrategy.
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