This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Iron metabolism and erythropoiesis after surgery. BJS 1998; 85: 41-45.
Published: 22nd January 2003
Authors: C. E. van Iperen, R. J. Kraaijenhagen, D. H. Biesma, Y. Beguin, J. J. M. Marx, A. van de Wiel et al.
Background
This was a prospective study comparing the effect of major and minor surgery on haematological variables concerning erythropoiesis, iron metabolism and acute‐phase response proteins.
Method
Thirty‐one otherwise healthy patients, 15 having major orthopaedic surgery and 16 undergoing minor surgery, were studied. Blood samples were taken before surgery and 1, 4, 10 and 28 days after operation.
Results
Haemoglobin concentration was decreased for up to 4 weeks after surgery. Serum erythropoietin concentration and reticulocyte count were raised after major surgery only. Serum iron concentration dropped the day after major (to 23 per cent of its preoperative level) and minor (to 46 per cent of its preoperative level) surgery and remained lower for up to 28 days after major surgery. Serum transferrin concentration and transferrin saturation decreased after both types of surgery while ferritin concentration increased. Serum transferrin receptor concentration increased only 4 weeks after major surgery (P < 0·01). The interleukin 6 peak (day 1) was greater after major than minor surgery, as was the C‐reactive protein peak (day 4).
Conclusion
Both major and minor surgery induce a state of hypoferraemia in the presence of adequate iron stores. The degree of this transient form of ‘anaemia of chronic disease’ is related to the extent of surgery. Iron supplementation in the first weeks after surgery (if iron stores were normal before operation) is ineffective. © 1998 British Journal of Surgery Society Ltd
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