{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:39:01Z","timestamp":1788493141701,"version":"build-2803163510"},"reference-count":15,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,8,13]],"date-time":"2014-08-13T00:00:00Z","timestamp":1407888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Bengt Ihre foundation","award":["SLS-100581, SLS-16989, SLS-247641,SLS-327911"],"award-info":[{"award-number":["SLS-100581, SLS-16989, SLS-247641,SLS-327911"]}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>The hypothesis tested in this study was that major blood loss during surgery for rectal cancer increases the risk for surgical complications and for small bowel obstruction (<jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content>) as a result of adhesions or tumour recurrence, and reduces overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Data were retrieved from the Uppsala\/\u00d6rebro Regional Rectal Cancer Registry for all patients undergoing radical resection for rectal cancer during 1997\u20132003 (<jats:italic>n<\/jats:italic>\u00a0=\u00a01843) and were matched against the Swedish National Patient Registry regarding surgery and admission for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content>. These patient records were scrutinized to determine the etiology of surgery for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content>. The registry was scrutinized for blood loss and other surgical complications associated with surgery. Uni\u2010 and multivariate Cox analysis and logistic regression were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Ninety\u2010four (5.1%) patients underwent surgery for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content> &gt;\u00a030\u00a0days after the index operation: 82 for adhesions and 12 for tumour recurrence. The volume of blood lost did not influence the risk of surgery for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content> as a result of adhesions, but blood loss above the median (\u2265\u00a0800\u00a0ml) increased the risk for surgery for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content> caused by tumour recurrence (hazard ratio\u00a0=\u00a010.52; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.36\u201381.51). Increased blood loss increased the risk of surgical complications (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.78; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 1.35\u20132.35 with blood loss of \u2265\u00a0450\u00a0ml) but did not reduce overall survival. Irradiation before surgery increased blood loss, complications and admission for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Major blood loss during surgery for rectal cancer increases the risk of later surgery for <jats:styled-content style=\"fixed-case\">SBO<\/jats:styled-content> caused by tumour recurrence and surgical complications, but overall survival is not affected.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.12630","type":"journal-article","created":{"date-parts":[[2014,4,9]],"date-time":"2014-04-09T13:50:59Z","timestamp":1397051459000},"page":"696-702","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Degree of blood loss during surgery for rectal cancer: a population\u2010based epidemiologic study of surgical complications and survival"],"prefix":"10.1111","volume":"16","author":[{"given":"M.","family":"Egenvall","sequence":"first","affiliation":[{"name":"Division of Surgery Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"M\u00f6rner","sequence":"additional","affiliation":[{"name":"Division of Surgery Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"P\u00e5hlman","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences Uppsala University Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"Gunnarsson","sequence":"additional","affiliation":[{"name":"Division of Surgery Department of Clinical Science Intervention and Technology Karolinska Institute Stockholm 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