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In a retrospective study data were collected from 644 patients with cancer of the colon or rectum undergoing curative surgery with extended lymphadenectomy to evaluate a possible effect of blood transfusion, given perioperatively, on tumor recurrence and patient survival. Univariate analysis showed depth of bowel wall invasion, number and level of lymph node metastases to be of highly significant prognostic factors. After 5 years the overall recurrence rate was 16.6% for the non-transfused (n = 223) and 26.1% for the transfused (n = 421; p < .01) patients, and survival rates showed borderline significance favoring the non-transfused patients (90.5% vs. 80.0% after 5 years; p < 0.05). However, after stratification for the prognostically important factors, in a multivariate analysis a possible detrimental effect of perioperative blood transfusions could not be demonstrated.

Background: Perioperative blood transfusion (BT) appeared to have adverse effects on survival after surgery for malignant tumors while pretransplantation BT suppressed allograft rejection. Interest grew in the effect of BT on postoperative recurrence of Crohn's disease., Study Design and Methods: To determine the effect of perioperative BT on the recurrence of Crohn's disease after primary surgery, the medical histories of 148 patients with Crohn's disease, 62 males and 86 females (49 nonparous and 37 parous), were reviewed. Eighty-seven patients received perioperative BT., Results: Overall, perioperative BT showed no effect on recurrence. Patients with Crohn's disease limited to the ileum had a better prognosis with regard to recurrence than did patients with Crohn's disease located in the colon or located in both ileum and colon, but the difference was not significant. Perioperative transfusion seemed to protect against recurrent disease after colon resection, which might be explained by the fact that colon resections, which often necessitate perioperative BT, generally result in a shorter bowel segment at risk for recurrent disease. Overall, parous women showed a worse prognosis than nonparous females and men (p = 0.022). Transfusions had a beneficial effect in parous women (p = 0.068) and, after correction for type of operation, this beneficial effect was significant (p = 0.026). After perioperative BT, parous women had a similar prognosis with respect to recurrent Crohn's disease as nonparous females and men., Conclusion: Perioperative BT has a beneficial effect on the postoperative recurrence of Crohn's disease in parous women.

The effect of perioperative blood transfusion on recurrence after primary operation was retrospectively studied in a group of 104 patients with Crohn's disease. Patients who had minor procedures like strictureplasty, segmental small-bowel resection, and operation for perianal fistula were excluded. Patients who had more extensive surgery were selected, to have an approximately equal distribution of blood transfusion in the different subgroups. Sixty-six female and 45 male patients were included; 65 patients had perioperative blood transfusion and 39 did not. Irrespective of blood transfusion it was confirmed that patients with small-bowel localization have a better prognosis than patients with combined or colonic localization. Patients who had resection of a specimen of less than 30 cm or more than 70 cm had a worse prognosis than the others. The reason for this observation is unclear. Except for patients with colonic localization only, blood transfusion was about equally distributed among patients with ileocaecal localization (19 of 36) and patients with ileal disease (17 of 34). Perioperative blood transfusion had no effect on disease recurrence, either for the whole group of transfused patients or for any of the subgroups, apart from those with colonic localization only. They had a significantly lower recurrence, as diagnosed before 60 months of follow-up. This is ascribed to the fact that these patients had large colonic resection with a lower chance of having active recurrent disease. In conclusion, we could not confirm the protective effects of blood transfusion on recurrence of Crohn's disease, as observed by others.