Abstract：
<b>Introduction:</b> The prevalence of preoperative anemia is the highest in the group of colorectal cancer (CRC) patients and may reach over 75%. The prevalence of anemia in CRC patients increases even further following surgery. Approximately 75-80% of anemic CRC patients present with absolute or functional iron deficiency (ID). Preoperative anemia constitutes an independent risk factor for allogeneic blood transfusion (ABT), postoperative complications, prolonged length of hospital stay, and increased mortality. ABT is itself associated with increased morbidity and mortality.<b>Aim:</b> The aim of this review article was to present the pathophysiology and the current approach to the diagnostics and treatment of preoperative iron deficiency anemia (IDA) in CRC patients.<b>Material and methods:</b> Extensive search of medical literature databases was performed (Pubmed, Embase). The key words that were used were as follows: CRC, colorectal surgery, ID, IDA, intravenous iron, Patient Blood Management (PBM).<b>Results:</b> There are several laboratory parameters that can be used for IDA diagnosis, however, the simplest and most cost- -effective is reticulocyte hemoglobin equivalent (RET-He). Pathophysiologic features of IDA in CRC patients favor treatment with intravenous, as opposed to oral, iron formulations. Applying PBM strategies minimizes the exposure to ABT.<b>Conclusions:</b> Preoperative IDA is highly prevalent among CRC patients. Preoperative anemia is an independent risk factor for ABT, increased morbidity and mortality, as well as prolonged hospital length of stay. The same negative consequences are associated with ABT. Therefore, preoperative IDA in CRC patients needs to be screened for, diagnosed, and treated before surgery. Effective treatment of preoperative IDA in CRC patients is with intravenous iron formulations. ABT should be the treatment of last resort due to the risk of negative clinical consequences, including an increased rate of cancer recurrence.
摘要：
<b>简介:</b>术前贫血的患病率在结直肠癌(CRC)患者组中最高,可能达到75%以上。手术后，CRC患者的贫血患病率进一步增加。大约75-80％的贫血CRC患者存在绝对或功能性缺铁（ID）。术前贫血是异体输血（ABT）的独立危险因素。术后并发症,住院时间延长,和死亡率增加。ABT本身与发病率和死亡率增加有关。＆lt;b＆gt;目的：＆lt;/b＆gt;这篇综述文章的目的是介绍CRC患者术前缺铁性贫血（IDA）的病理生理学和当前诊断和治疗方法。<b>材料和方法:</b>对医学文献数据库进行了广泛的搜索(Pubmed,Embase)。使用的关键词如下：CRC，结直肠手术,ID,IDA,静脉注射铁,患者血液管理(PBM)。<b>结果:</b>有几个实验室参数可用于IDA诊断,然而,最简单和最具成本效益的是网织红细胞血红蛋白当量(RET-He)。CRC患者IDA的病理生理学特征倾向于静脉内治疗，与口头相反，铁配方。应用PBM策略最大限度地减少了对ABT的暴露。结论：</b>术前IDA在CRC患者中非常普遍。术前贫血是ABT的独立危险因素,发病率和死亡率增加，以及延长住院时间。同样的负面后果与ABT有关。因此,CRC患者的术前IDA需要进行筛查，诊断，并在手术前治疗。CRC患者术前IDA的有效治疗是静脉内铁制剂。由于存在负面临床后果的风险，ABT应该是最后的治疗手段，包括癌症复发率的增加。
