DOI: 10.1093/bjs/znad241.518 ISSN:

602 A simple and timely intervention can optimise patient’s anaemia before resectional surgery for Colorectal cancer

Umar Shafiq, Anil Agarwal, Christopher Boulos
  • Surgery



Anaemia at the time of colorectal resection for cancer adversely affects outcomes. We performed an audit to quantify anaemia at pre-assessment. We incorporated an intervention of iron infusion at the point of diagnostic endoscopy for suspected cancers with anaemia. We assessed the improvement of anaemia in these patients at pre-assessment.


Patient records and blood results were used to determine haemoglobin levels and any treatment given for anaemia from referral to surgery. These included 53 anaemic patients in the pre-intervention group and 8 anaemic patients so far in the post-intervention group. The effect of the intervention was analysed.


Pre-intervention 62.4% of patients undergoing right hemicolectomy were anaemic at pre-assessment. 32.1% had a Hb <100 g/L; 47.1% of these were treated.

In the other group, 50% of anaemic patients had a Hb of <100 g/L at colonoscopy; 75% of these patients improved their Hb at pre-assessment to >100 g/L after receiving the iron infusion.


The treatments to correct anaemia in the control group were varied and inconsistent. It's routine that the colorectal nurses are informed of cancer diagnosis at the time of diagnostic endoscopy. The intervention used was for them to arrange iron infusion for patients found to be anaemic on a recent FBC. This intervention was easily incorporated in the patient pathway and required no extra resources. The infusion allowed sufficient time for the anaemia to improve before the operation. This simple and timely intervention can be widely implemented, and we recommend its use.

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