Background and Goal of Study:Preoperative anaemia is associated with an increase in perioperative mortality. Enhanced recovery after surgery (ERAS) protocols recommend the detection of anaemia to reach a preoperative hemoglobin within the margins of normality defined by the World Health Organization (WHO) (men≥13 g/dl; women≥12 g/dl).
Materials and Methods:A total of 256 patients were included. We compared the first 121 consecutive patients that participated in the ERAS (from May 2016 to January 2017) with 135 consecutive patients that were operated prior to implementation of the program (from January to December 2015). The
inclusion criteria were: elective colorectal surgery, ≥18 years, appropriate cognitive state and ASA (American Society of Anaesthesiology) I-II-III. The exclusion criteria were: urgent surgery and existence of higher concomitant surgical processes. The main variables of the study were preoperative hemoglobin, number of patients transfused and number of red blood cell transfusions during the hospital
stay. The statistical analysis was performed with the SPSS software. The Chi-square, Fisher's test or tStudent statistical tests were applied as appropriate. The results were considered statistically significant when p <0.05.
Results and Discussion:There were no statistically significant differences between groups in terms of age, sex, ASA, diagnosis or preoperative hemoglobin. Statistically significant differences were found in the surgical approach, with more patients underwent laparoscopy in the ERAS group: 27 (20%) vs 45 (37.2%), p 0.006.
A total of 31 patients (22.96%) were transfused in the pre-ERAS group versus 15 (12.4%) in the ERAS group, with a statistically significant difference (p 0.028). There was a lower number of red blood cells transfusions in the ERAS group because of the application of the preoperative anaemia correction protocol (3 ± 1.57 vs 1.8 ± 0.56, p <0.001). No significant differences were found between patients who
received oral iron or not, but the difference reach statistical significance in those who received intravenous iron administration (3 (2.23%) vs 31 (25.6%), p <0.001).
Conclusion(s):The application of a pre-operative anaemia optimization protocol in patients undergoing elective colorectal surgery according to ERAS guide allowed a reduction in the number of red blood cell transfusions and in the total number of patients transfused.

11 / RESULTS AFTER THE IMPLEMENTATION OF A PREOPERATIVE ANAEMIA CORRECTION PROTOCOL IN ELECTIVE COLORECTAL SURGERY WITH AN “ERAS” PROTOCOL: A PROSPECTIVE COHORT STUDY