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<p>Anemia is prevalent among surgical patients, particularly in those undergoing pancreatic surgery, and is associated with increased morbidity and mortality. Iron isomaltoside (IIM), a novel intravenous iron formulation, has demonstrated efficacy in correcting anemia with lower risk of side effects. This study aims to evaluate the efficacy of IIM in managing perioperative anemia in patients undergoing robotic pancreatic surgery. Our study included 90 consecutive patients underwent robotic pancreatic surgery at Peking Union Medical College Hospital (PUMCH) from June 2023 to June 2024. After exclusion, a total of 84 patients were categorized into a control group (<i>n</i> = 70) and an IIM group (<i>n</i> = 14). Baseline characteristics, surgical outcomes, and hemoglobin levels were compared. Propensity score matching (PSM) was used to adjust for baseline differences. Hemoglobin concentrations were assessed before surgery and on postoperative days (POD) 1, 3, 7, and 30. Preoperative hemoglobin were significantly lower in IIM group (115.86 ± 22.76&#xa0;g/L) compared to control group (132.69 ± 13.96&#xa0;g/L, <i>p</i> = 0.018). Postoperatively, hemoglobin levels declined in both groups, reaching their lowest on POD 1, and gradually increased thereafter. By POD30, the hemoglobin levels of patients in IIM group had caught up with control group (119.36 ± 9.04 vs. 120.11 ± 12.27&#xa0;g/L, <i>p</i> = 0.827). The changes in hemoglobin levels (Δ) demonstrated significant improvements in the IIM group. At POD1, the decrease in hemoglobin was significantly smaller in the IIM group compared to the control group (ΔPOD1: -3.93 ± 13.79 vs. -15.41 ± 12.50, <i>P</i> = 0.003). Similar trends were observed at POD7 (ΔPOD7: -6.14 ± 19.42 vs. -18.47 ± 12.12, <i>P</i> = 0.037) and at POD30, where the IIM group showed an increase in hemoglobin levels compared to a decrease in the control group (ΔPOD30: 3.50 ± 19.78 vs. -12.57 ± 12.67, <i>P</i> = 0.010). After PSM to account for differences in baseline characteristics, the changes in hemoglobin levels (Δ) postoperatively continued to show significant improvements in the IIM group. Surgical outcomes, including operative time, blood loss, transfusion rates, and postoperative complications, were comparable between these two groups before and after PSM. There were no side effects due to the administration of intravenous IIM. IIM could effectively improve postoperative hemoglobin levels in patients undergoing robotic pancreatic surgery.</p>

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Preoperative iron isomaltoside administration enhances postoperative anemia recovery in robotic pancreatic surgery

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Tianyu Li,
  • Yutong Zhao,
  • Liangbo Dong,
  • Jiashu Han,
  • Bangbo Zhao,
  • Chen Lin,
  • Weibin Wang

摘要

Anemia is prevalent among surgical patients, particularly in those undergoing pancreatic surgery, and is associated with increased morbidity and mortality. Iron isomaltoside (IIM), a novel intravenous iron formulation, has demonstrated efficacy in correcting anemia with lower risk of side effects. This study aims to evaluate the efficacy of IIM in managing perioperative anemia in patients undergoing robotic pancreatic surgery. Our study included 90 consecutive patients underwent robotic pancreatic surgery at Peking Union Medical College Hospital (PUMCH) from June 2023 to June 2024. After exclusion, a total of 84 patients were categorized into a control group (n = 70) and an IIM group (n = 14). Baseline characteristics, surgical outcomes, and hemoglobin levels were compared. Propensity score matching (PSM) was used to adjust for baseline differences. Hemoglobin concentrations were assessed before surgery and on postoperative days (POD) 1, 3, 7, and 30. Preoperative hemoglobin were significantly lower in IIM group (115.86 ± 22.76 g/L) compared to control group (132.69 ± 13.96 g/L, p = 0.018). Postoperatively, hemoglobin levels declined in both groups, reaching their lowest on POD 1, and gradually increased thereafter. By POD30, the hemoglobin levels of patients in IIM group had caught up with control group (119.36 ± 9.04 vs. 120.11 ± 12.27 g/L, p = 0.827). The changes in hemoglobin levels (Δ) demonstrated significant improvements in the IIM group. At POD1, the decrease in hemoglobin was significantly smaller in the IIM group compared to the control group (ΔPOD1: -3.93 ± 13.79 vs. -15.41 ± 12.50, P = 0.003). Similar trends were observed at POD7 (ΔPOD7: -6.14 ± 19.42 vs. -18.47 ± 12.12, P = 0.037) and at POD30, where the IIM group showed an increase in hemoglobin levels compared to a decrease in the control group (ΔPOD30: 3.50 ± 19.78 vs. -12.57 ± 12.67, P = 0.010). After PSM to account for differences in baseline characteristics, the changes in hemoglobin levels (Δ) postoperatively continued to show significant improvements in the IIM group. Surgical outcomes, including operative time, blood loss, transfusion rates, and postoperative complications, were comparable between these two groups before and after PSM. There were no side effects due to the administration of intravenous IIM. IIM could effectively improve postoperative hemoglobin levels in patients undergoing robotic pancreatic surgery.