@article {Lidder:May 2007:0035-8843:418,
	author = "Lidder, P.G.",
	author = "Sanders, G.",
	author = "Whitehead, E.",
	author = "Douie, W.J.",
	author = "Mellor, N.",
	author = "Lewis, S.J.",
	author = "Hosie, K.B.",
	title = "Pre-operative oral iron supplementation reduces blood transfusion in colorectal surgery a prospective, randomised, controlled trial",
	journal = "Annals of The Royal College of Surgeons of England",
	volume = "89",
	year = "May 2007",
	abstract = "INTRODUCTION: Allogeneic blood transfusion confers a risk to the recipient. Recent trials in colorectal surgery have shown that the most significant factors predicting blood transfusion are pre-operative haemoglobin, operative blood loss and presence of a transfusion protocol. We report a randomised, controlled trial of oral ferrous sulphate 200 mg TDS for 2 weeks' pre-operatively versus no iron therapy.<P></P>PATIENTS AND METHODS: Patients diagnosed with colorectal cancer were recruited from out-patient clinic and haematological parameters assessed. Randomisation was co-ordinated via a telephone randomisation centre.<P></P>RESULTS: Of the 49 patients recruited, 45 underwent colorectal resection. There were no differences between those patients not receiving iron (<I>n</I> = 23) and the iron-supplemented group (<I>n</I> = 22) for haemoglobin at recruitment, operative blood loss, operation duration or length of hospital stay. At admission to hospital, the iron-supplemented group had a higher haemoglobin than the non-iron treated group (mean haemoglobin concentration 13.1 g/dl [range, 9.6-17 g/dl] versus 11.8 g/dl [range, 7.8-14.7 g/dl]; P = 0.040; 95% CI 0.26-0.97) and were less likely to require operative blood transfusion (mean 0 U [range, 0-4 U] versus 2 U [range, 0-11 U] transfused; <I>P</I> = 0.031; 95% CI 0.13-2.59). This represented a cost reduction of 66% (47 U of blood = &#163;4700 versus oral FeSO<SUB>4</SUB> at &#163;30 + 15 U blood at &#163;1500). At admission, ferritin in the iron-treated group had risen significantly from 40 &#956;g/l (range, 15-222 &#956;g/l) to 73 &#956;g/l (range, 27-386 &#956;g/l; <I>P</I> = 0.0036; 95% CI 46.53-10.57).<P></P>CONCLUSIONS: Oral ferrous sulphate given pre-operatively in patients undergoing colorectal surgery offers a simple, inexpensive method of reducing blood transfusions.",
	pages = "418-421(4)",
	url = "http://www.ingentaconnect.com/content/rcse/arcs/2007/00000089/00000004/art00019"
	doi = "doi:10.1308/003588407X183364"
}