{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:51:29Z","timestamp":1781628689494,"version":"3.54.5"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T00:00:00Z","timestamp":1766793600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":40,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"peking university international hospital","award":["YN2023ZD04"],"award-info":[{"award-number":["YN2023ZD04"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the impact of preoperative anemia incidence of severe complications and short-term clinical outcomes in patients undergoing retroperitoneal tumor resection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study, enrolling patients with retroperitoneal tumors who received resection at Peking University International Hospital from January 2015 to December 2023. Patient baseline data were collected, and the following outcome measures were recorded:\u200b<\/jats:p>\n                    <jats:p>\u2022 The primary outcome measure was the grade of postoperative complications;<\/jats:p>\n                    <jats:p>\u2022The secondary outcome measures included duration of mechanical ventilation, length of ICU stay, postoperative hospital stay, total hospital stay, postoperative 24-hour mortality, and postoperative 30-day mortality.\u200b<\/jats:p>\n                    <jats:p>Patients were divided into an anemia group and a non-anemia group according to the World Health Organization (WHO) criteria for anemia to analyze the effect of preoperative anemia on the aforementioned indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 1968 patients were included in this study, among whom 1100 (465 males and 635 females) had preoperative anemia, with an incidence rate of 55.9%. Statistically significant differences were noted between the two groups in terms of gender, age, body mass index (BMI), American Society of Anesthesiologists (ASA) physical status classification, and number of previous surgeries (all\n                      <jats:italic>P<\/jats:italic>\n                      &lt; 0.05). Specifically, the anemia group exhibited a higher proportion of female patients, older age, lower BMI, a higher percentage of patients with ASA class III or IV, more patients with two or more previous surgeries, longer operation duration, and longer anesthesia duration compared with the non-anemia group.\n                    <\/jats:p>\n                    <jats:p>Compared to the non-anemia group, the anemia group had a higher incidence of severe postoperative complications, along with significantly prolonged duration of mechanical ventilation, length of ICU stay, postoperative hospital stay, and total hospital stay. In the entire cohort, 4 patients (0.2%) died within 24 hours postoperatively, and 20 patients (1.0%) died within 30 days postoperatively.<\/jats:p>\n                    <jats:p>Multivariate analysis, after adjusting for confounding factors including gender, age, and BMI, revealed that patients in the preoperative anemia group had a significantly increased risk of severe postoperative complications, as well as significantly prolonged duration of mechanical ventilation, ICU stay, postoperative hospital stay, and total hospital stay. Preoperative anemia was not correlated with mortality at 24 hours or 30 days after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Preoperative anemia is an independent risk factor for increased incidence of severe postoperative complications, as well as prolonged duration of mechanical ventilation, length of ICU stay, total hospital stay, and postoperative hospital stay in patients undergoing retroperitoneal tumor resection. Proactive management of preoperative anemia is critical for reducing postoperative complications and enhancing clinical outcomes in patients undergoing retroperitoneal tumor resection, thereby offering valuable insights for optimizing perioperative care in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12871-025-03573-2","type":"journal-article","created":{"date-parts":[[2025,12,27]],"date-time":"2025-12-27T11:04:12Z","timestamp":1766833452000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of preoperative anemia on postoperative rate of severe complications and short-term clinical outcomes after retroperitoneal tumor resection"],"prefix":"10.1186","volume":"26","author":[{"given":"Subing","family":"Guo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyang","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haoyao","family":"Dong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Yao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunpeng","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,27]]},"reference":[{"key":"3573_CR1","doi-asserted-by":"crossref","unstructured":"Messiou C, Moskovic E, Vanel D, et al. Primary retroperitoneal soft tissue sarcoma: imaging appearances, pitfalls and diagnostic algorithm. Eur J Surg Oncol. 2017;43(7) :1191\u20138.","DOI":"10.1016\/j.ejso.2016.10.032"},{"key":"3573_CR2","doi-asserted-by":"crossref","unstructured":"Carlo A, Lorenzo B, Claudio L, et al. Impact of severe postoperative complications and P-POSSUM score on oncological outcomes in primary retroperitoneal sarcoma: insights from a tertiary cancer center [J]. Cancers (Basel). 2025;17(11):1787.","DOI":"10.3390\/cancers17111787"},{"key":"3573_CR3","doi-asserted-by":"crossref","unstructured":"Jun W, Jun C, Kunpeng L, et al. Anesthetic managements, morbidities and mortalities in retroperitoneal sarcoma patients experiencing perioperative massive blood transfusion [J]. Front Oncol. 2024;14:1347248.","DOI":"10.3389\/fonc.2024.1347248"},{"key":"3573_CR4","doi-asserted-by":"crossref","unstructured":"Sylvie B, Michel R, Marine C, et al. Primary retroperitoneal sarcomas: a multivariate analysis of surgical factors associated with local control [J]. J Clin Oncol. 2009;27(1):31\u20137.","DOI":"10.1200\/JCO.2008.18.0802"},{"key":"3573_CR5","doi-asserted-by":"crossref","unstructured":"Franziska W, Anna-Marlen T, Julian M, et al. Temporal variation in nutritional status and preoperative anemia among patients with retroperitoneal soft tissue sarcoma: a retrospective longitudinal cohort study [J]. Langenbecks Arch Surg. 2025;410(1):48.","DOI":"10.1007\/s00423-024-03585-5"},{"key":"3573_CR6","doi-asserted-by":"crossref","unstructured":"Yixu D, Meilin W, Jun Z. Preoperative anemia and long-term survival in patients undergoing colorectal cancer surgery: a retrospective cohort study [J]. World J Surg Oncol. 2023;21(1)122.","DOI":"10.1186\/s12957-023-03005-w"},{"key":"3573_CR7","doi-asserted-by":"publisher","first-page":"940428","DOI":"10.3389\/fonc.2022.940428","volume":"12","author":"M WENG","year":"2022","unstructured":"Weng M, Guo M, Li, et al. Anemia tolerance versus blood transfusion on long-term outcomes after colorectal cancer surgery: a retrospective propensity-score-matched analysis [J]. Front Oncol. 2022;12:940428.","journal-title":"Front Oncol"},{"issue":"1","key":"3573_CR8","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1186\/s13018-024-04706-y","volume":"19","author":"F ZHANG","year":"2024","unstructured":"Zhang F, Yang Y, Li P, et al. Impact of preoperative anemia on patients undergoing total joint replacement of lower extremity: a systematic review and meta-analysis [J]. J Orthop Surg Res. 2024;19(1):249.","journal-title":"J Orthop Surg Res"},{"key":"3573_CR9","doi-asserted-by":"crossref","unstructured":"Molla MT, Endeshaw AS, Asfaw G, et al. The association between preoperative anemia and postoperative mortality among non-cardiac surgical patients in Northwest ethiopia: a prospective cohort study [J]. BMC Anesthesiol. 2025;25(1):19.","DOI":"10.1186\/s12871-025-02900-x"},{"key":"3573_CR10","doi-asserted-by":"crossref","unstructured":"Attri G, philip JF, Shane S, et al. Preoperative anemia is an unsuspecting driver of machine learning prediction of adverse outcomes after lumbar spinal fusion [J]. Spine J. 2025;25(8):1596\u2013607.","DOI":"10.1016\/j.spinee.2025.01.031"},{"key":"3573_CR11","doi-asserted-by":"crossref","unstructured":"Yannick JJMH, Peter GN, Bastiaan MG, et al. Preoperative anaemia and outcome after elective cardiac surgery: a Dutch National registry analysis [J]. Br J Anaesth,. 2022;128(4):636\u201343.","DOI":"10.1016\/j.bja.2021.12.016"},{"issue":"4","key":"3573_CR12","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1007\/s00701-022-05144-7","volume":"164","author":"E SCHMITT","year":"2022","unstructured":"Schmitt E, Meybohm P, et al. Preoperative anaemia and red blood cell transfusion in patients with aneurysmal subarachnoid and intracerebral haemorrhage \u2014 a multicentre subanalysis of the German PBM network registry [J]. Acta Neurochir. 2022;164(4):985\u2013 99.","journal-title":"Acta Neurochir"},{"issue":"5","key":"3573_CR13","doi-asserted-by":"publisher","first-page":"959","DOI":"10.1097\/SLA.0000000000002250","volume":"267","author":"A MACNEILL","year":"2018","unstructured":"Macneill A, Gronchi A, Miceli R, et al. Postoperative morbidity after radical resection of primary retroperitoneal sarcoma: a report from the transatlantic RPS working group [J]. Ann Surg. 2018;267(5):959\u201364.","journal-title":"Ann Surg"},{"key":"3573_CR14","unstructured":"Clarissa PS, Matthew CC, Julie H, et al. Preoperative anemia and iron deficiency in elective Gastrointestinal cancer surgery patients [J]. J Surg Oncol. 2025;31(4):614\u201323."},{"key":"3573_CR15","doi-asserted-by":"crossref","unstructured":"Joseph PC, Eric D, Daniel R, et al. Pre-operative anemia and peri-operative transfusion are associated with poor oncologic outcomes in cancers of the esophagus: potential impact of patient blood management on cancer outcomes [J]. BMC Cancer. 2023;23(1):99.","DOI":"10.1186\/s12885-023-10579-x"},{"key":"3573_CR16","doi-asserted-by":"crossref","unstructured":"Clelia M, Giulia G, Giorgio A, et al. Pathogenesis and treatment options of cancer related anemia: perspective for a targeted mechanism-based approach [J]. Front Physiol. 2018;9.","DOI":"10.3389\/fphys.2018.01294"},{"key":"3573_CR17","doi-asserted-by":"crossref","unstructured":"Samantha MR, Victor H, David JK, et al. Radiation therapy for retroperitoneal sarcoma: practice patterns in North America [J]. Radiat Oncol. 2024;19(1):38.","DOI":"10.1186\/s13014-024-02407-8"},{"key":"3573_CR18","doi-asserted-by":"crossref","unstructured":"A G A MM, M A, et al. International consensus statement on the peri-operative management of anaemia and iron deficiency [J]. Anaesthesia. 2017;72(2)233\u201347.","DOI":"10.1111\/anae.13773"},{"key":"3573_CR19","doi-asserted-by":"crossref","unstructured":"Hannah LT James H, Kenneth C, et al. Primary mesenteric sarcomas: collaborative experience from the Trans-Atlantic Australasian retroperitoneal sarcoma working group (TARPSWG) [J]. J Surg Oncol. 2021;123(4):1057\u201366.","DOI":"10.1002\/jso.26353"},{"key":"3573_CR20","doi-asserted-by":"crossref","unstructured":"Godeshala S, Surendar Reddy B, Rajkumar B. Development of new estradiol-cationic lipid hybrids: ten-carbon twin chain cationic lipid is a more suitable partner for estradiol to elicit better anticancer activity [J]. Eur J Med Chem. 2014;86:653\u20133.","DOI":"10.1016\/j.ejmech.2014.09.030"},{"key":"3573_CR21","doi-asserted-by":"crossref","unstructured":"Sayantani R, Bathula Surendar R, GODESHALA S, et al. 17\u03b2-estradiol-linked nitro-L-arginine as simultaneous inducer of apoptosis in melanoma and tumor-angiogenic vascular endothelial cells [J]. Mol Pharm. 2011;8(2)350\u20139.","DOI":"10.1021\/mp2000346"},{"key":"3573_CR22","doi-asserted-by":"crossref","unstructured":"Li L, Jianguo F, Ying C, et al. Estradiol shows anti-skin cancer activities through decreasing MDM2 expression [J]. Oncotarget. 2017;8(5):8459\u201374.","DOI":"10.18632\/oncotarget.14275"},{"key":"3573_CR23","doi-asserted-by":"crossref","unstructured":"Gustavo De Carvalho D, Glaciano Nogueira R, Mariangela M, et al. Targeting patient blood management\u2019s first pillar: a multicentric retrospective study on preoperative anemia [J]. Hematol Transfus Cell Ther. 2023;45(3)338\u201341.","DOI":"10.1016\/j.htct.2022.06.001"},{"key":"3573_CR24","doi-asserted-by":"crossref","unstructured":"Reinhard S, Peter V, Igor T. Anemia at older age: etiologies, clinical implications, and management [J]. Blood. 2018;131(5): 505\u201314.","DOI":"10.1182\/blood-2017-07-746446"},{"issue":"9800","key":"3573_CR25","doi-asserted-by":"publisher","first-page":"1396","DOI":"10.1016\/S0140-6736(11)61381-0","volume":"378","author":"T MUSALLAM K M, TAMIM H M, RICHARDS","year":"2011","unstructured":"Musallam K M, Tamim H M, Richards T, et al. Preoperative anaemia and postoperative outcomes in non-cardiac surgery: a retrospective cohort study [J]. Lancet. 2011;378(9800):1396\u2013407.","journal-title":"Lancet"},{"key":"3573_CR26","doi-asserted-by":"crossref","unstructured":"Adrienne B, S Yuns, Lauren B D R, et al. Preoperative transfusion for anemia in patients undergoing abdominal surgery for malignancy [J]. J Gastrointest Surg. 2021;25(6)1534\u201344.","DOI":"10.1007\/s11605-020-04656-w"},{"issue":"12","key":"3573_CR27","first-page":"766","volume":"79","author":"S BOUMAHD","year":"2024","unstructured":"Boumahd S, Piette N, et al. Preoperative anemia: a review of its prognostic implications, diagnosis and management [J]. Rev Med Liege. 2024;79(12):766\u201370.","journal-title":"Rev Med Liege"},{"key":"3573_CR28","doi-asserted-by":"crossref","unstructured":"A J F ,T A, M K P, et al. Meta-analysis of the association between preoperative anaemia and mortality after surgery [J]. Br J Surg. 2015;102(11):1314\u201324.","DOI":"10.1002\/bjs.9861"},{"key":"3573_CR29","doi-asserted-by":"crossref","unstructured":"Baikady R, Eeles A. Peri-operative blood management [J]. Indian J Anaesth. 2017;61(6)L:456\u201362.","DOI":"10.4103\/ija.IJA_341_17"},{"issue":"2","key":"3573_CR30","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1111\/j.1365-2133.2010.09804.x","volume":"163","author":"S SCHREML","year":"2010","unstructured":"Schreml S, Szeimies R, Prantl L, et al. Oxygen in acute and chronic wound healing [J]. Br J Dermatol. 2010;163(2):257\u201368.","journal-title":"Br J Dermatol"},{"key":"3573_CR31","doi-asserted-by":"crossref","unstructured":"Rozita K, Mahmoud T, Gorgon AF, Leyla F, et al. Adipose tissue dysfunction following trauma and hypoxia increases the risk of Post-Surgical adhesion: potential for therapeutic interventions. Curr Mol Pharmacol. 2024;17:e18761429308567.","DOI":"10.2174\/0118761429308567240806111848"},{"key":"3573_CR32","doi-asserted-by":"crossref","unstructured":"Stefan W L, Nicolas J M Richardl, et al. Does preoperative anemia adversely affect colon and rectal surgery outcomes? [J]. J Am Coll Surg. 2011;212(2):187\u201394.","DOI":"10.1016\/j.jamcollsurg.2010.09.013"},{"issue":"1","key":"3573_CR33","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1186\/s12871-023-02235-5","volume":"23","author":"Z ZHENG","year":"2023","unstructured":"Zheng Z, Yang Pengs, et al. The relationship between preoperative anemia and length of hospital stay among patients undergoing radical surgery for esophageal carcinoma: a single-centre retrospective study [J]. BMC Anesthesiol. 2023;23(1):322.","journal-title":"BMC Anesthesiol"},{"key":"3573_CR34","doi-asserted-by":"crossref","unstructured":"David M-A, Manish M S, Dean A F, et al. Blood transfusion and the risk for infections in kidney transplant patients [J]. PLoS ONE. 2021;16(11):e0259270.","DOI":"10.1371\/journal.pone.0259270"},{"key":"3573_CR35","doi-asserted-by":"crossref","unstructured":"A A K, T J C MSB, et al. The incidence and importance of anaemia in patients undergoing cardiac surgery in the UK - the first association of cardiothoracic anaesthetists National audit [J]. Anaesthesia. 2016;71(6):627\u201335.","DOI":"10.1111\/anae.13423"},{"key":"3573_CR36","doi-asserted-by":"crossref","unstructured":"Sarhane KA, Flores JM, Cooney CM, et al. Preoperative anemia and postoperative outcomes in immediate breast reconstructive surgery [J]. Plast Reconstr Surg Global Open. 2013;1(5):e30.","DOI":"10.1097\/GOX.0b013e3182a18c6f"},{"key":"3573_CR37","doi-asserted-by":"crossref","unstructured":"A A M VM, C J, et al. Management of peri-surgical anemia in elective surgery. Conclusions and recommendations according to Delphi-UCLA methodology [J]. Rev Esp Anestesiol Reanim (Engl Ed). 2024;71(6) :454\u201365.","DOI":"10.1016\/j.redare.2024.04.015"},{"issue":"03","key":"3573_CR38","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1055\/s-0043-1760868","volume":"36","author":"TE LYNCH K T, HASSINGER","year":"2023","unstructured":"Lynch K T, Hassinger TE. Preoperative identification and management of anemia in the colorectal surgery patient [J]. Clin Colon Rectal Surg. 2023;36(03):161\u20136.","journal-title":"Clin Colon Rectal Surg"},{"key":"3573_CR39","doi-asserted-by":"publisher","first-page":"S17","DOI":"10.1016\/j.htct.2024.02.006","volume":"46","author":"F BENITES B D, LEITE","year":"2024","unstructured":"Benites B D, Leite F, Soriano S, et al. Consensus of the Brazilian association of hematology, hemotherapy and cellular therapy on patient blood management [J]. Hematol Transfus Cell Therapy. 2024;46:S17\u201323.","journal-title":"Hematol Transfus Cell Therapy"},{"issue":"5","key":"3573_CR40","doi-asserted-by":"publisher","first-page":"410","DOI":"10.2174\/0115665232279426240217174738","volume":"24","author":"AS Bozkurt","year":"2024","unstructured":"Bozkurt AS, Y\u0131lmaz \u015eG. Effect of bovine lactoferrin treatment on iron homeostasis and gene expression changes in multiple organ dysfunctions during wound healing process in rats. Curr Gene Ther. 2024;24(5):410\u201321.","journal-title":"Curr Gene Ther"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03573-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03573-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03573-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T15:51:35Z","timestamp":1781625095000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12871-025-03573-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,27]]},"references-count":40,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3573"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03573-2","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-8145925\/v1","asserted-by":"object"}]},"ISSN":["1471-2253"],"issn-type":[{"value":"1471-2253","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,27]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors gave their content for publication.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"91"}}