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Introduction: Primary tumor resection can prevent future tumor-related complications in patients with stage IV colorectal cancer. This may influence the quality of life and prevent colostomies associated with the emergency surgery. Laparoscopic approach plays an important role in attempts to reduce perioperative complications in this specific group of patients. Purpose: The aim is to assess early perioperative results in a group of 17 patients with stage IV colorectal cancer—multiple incurable liver metastases and/or pulmonary/peritoneal metastases of the disease. On the other hand, postoperative complications may delay administration of chemotherapy and influence survival. Materials and methods: We analyze retrospectively the perioperative results in a group of 17 patients with laparoscopic palliative colorectal resections for stage IV colorectal cancer. Assessment includes perioperative complications, median hospital stay, perioperative blood loss, need for blood transfusion, operative time, and type of surgical procedure. Results: We performed totally laparoscopic 10 sigmoid resections, five left colectomies, and two right colectomies. Fourteen simultaneous liver biopsies were performed during laparoscopy. No perioperative deaths were registered. Perioperative mortality rate is 0%. Perioperative morbidity rate is 0%. No perioperative complications. The median perioperative stay is 5.3 days. Median blood loss is 47.9 mL. Overall, three units of blood were transfused. The median transfusion rate is 0.17 units per patient. The median operative time is 130.2 minutes. Conclusion: The laparoscopic approach is associated with very good perioperative results in patients with stage IV colorectal cancer and palliative resection of the primary tumor. Early hospital discharge and minimal operative trauma may not influence early administration of chemotherapy.

The aim of this study is to assess the risk for immune and hematologic adverse events in perioperative transfusion of blood components. Our second goal is to propose methods for the selection of an optimally compatible donor in order to limit the negative impact of complications following blood component transfusion on the hospital outcome of patients admitted to clinics of general, gastrointestinal, thoracic, and vascular surgery. The largest group of patients included in this study were patients with gastrointestinal disorders (614 patients; 31%) and patients with diseases of the organs of the blood and lymphatic system (589 patients; 30%). This was followed by patients with diseases of the skin and subcutaneous tissue (368 patients; 18%) and patients with benign and malignant neoplasms (365 patients; 18%). The remaining 65 patients (3%) were diagnosed with diseases of the endocrine system, trauma patients, and patients with genitourinary disorders. The methods used for optimal selection of compatible blood components in this study are enzyme tests, Coombs tests, and tests in agglutinating medium. The study shows that clinically significant antibodies, which could provoke a post-transfusion hemolytic reaction, were detected in 4.3% of the screened patients. In the majority of patients, the specificity of antierythrocyte antibodies cannot be established. For those patients where the specificity of anti-erythrocyte antibodies could be established, the type of antibody and the antigen system to which it belonged were as follows (in descending order): 1. Anti-erythrocyte antibodies belonging to the Rh system: 37% (n = 17) of all screened patients (1.6% of all patients), including anti-E type (5 patients), anti-D (8 patients), anti-C-1, anti-C (2 patients), and anti-Cw (1 patient). 2. In 3 (6% or anti-erythrocyte antibodies belonging to other erythrocyte antigen systems—Kidd-1 patients, Lewis-2 patients—6% of the screened patients (0.3% of all patients). 3. In 57% (n = 26) of those screened (2.4% of all patients), alloantibodies without any known specificity were identified. The largest number of identified antibodies were directed against the D antigen belonging to the Rh system. Most of the anti-D alloantibodies found in Rhesus D (-) negative patients with no history of prior transfusion of D (+) positive red blood cell (RBC) concentrate possibly have resulted from prior Rh isoimmunization during pregnancy, provided that anti-D antibodies persist for a long time after birth—in some of the studied patients, 15–20 or more years. A greater number of alloimmunizations were found in women—28 (61%), compared to men—18 (39%), due to previous sensitization with different blood group antigens during pregnancy. This study shows that timely diagnosis is essential for the selection of appropriate RBC concentrate, for the avoidance of adverse reactions, and for the improvement of hematological parameters after transfusion of blood components. Graphical abstract: