Cirugía española
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Review
[Anaemia, iron, transfusion and therapeutic alternatives. A review from a surgical perspective].
Anemia is very common entity or comorbidity in surgical patients. Its management involves a multidisciplinary approach with the aim of optimizing the available therapeutic resources with individualized care for each clinical situation. Rational use of blood transfusions, iron therapy (oral and intravenous), erythropoiesis stimulating agents and other therapeutic alternatives by physicians must achieve maximal benefit with minimal complications for our patients. This review article summarizes the main characteristics of anemia, iron metabolism, erythropoiesis and therapeutic alternatives from a surgical perspective in the light of present knowledge.
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The aim of the study was to evaluate the relationship between the pre-surgical administration of a chemotherapy regime based on irinotecan or oxaliplatin and the development of non-alcoholic fatty liver disease (NAFLD) or sinusoidal obstruction syndrome (SOS), and the influence of these histological changes on the outcome of patients after surgical intervention. ⋯ Treatment with irinotecan was significantly associated with an increase in the incidence of steatohepatitis, but did not increase the morbidity or mortality. Patients treated with oxaliplatin had a higher incidence of SOS, an increase in liver complications and a longer mean hospital stay.