{
  "abstract": "Background/Objectives: Deep endometriosis surgery may require bowel and multiorgan procedures, but reported blood loss and complications do not fully characterize postoperative hemoglobin decline, a relevant consideration for patient blood management. We aimed to quantify the frequency of a hemoglobin decline of ≥3 g/dL and its association with surgery duration, with secondary exploratory analyses of operative extent. Methods: This retrospective single-center study in Opole, Poland, linked registry and laboratory records for first eligible surgeries during 2020–2025. Decline was the last preoperative hemoglobin within 7 days minus the recorded nadir through postoperative day 3. The ≥3 g/dL threshold was operational, not a validated minimum clinically important difference. Multivariable models examined binary and continuous decline; exploratory analyses assessed operative extent. Results: Among 424 patients, preoperative hemoglobin was <12 g/dL in 41/419 (9.8%) and <13 g/dL in 152/419 (36.3%). Of 416 with both measurements, 156 (37.5%) met the endpoint, whose ascertainment depended on available recorded postoperative measurements. Each additional hour was associated with higher odds (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.35–1.91), including without preoperative hemoglobin (OR, 1.50; 95% CI, 1.28–1.76). Continuous decline was 0.20 g/dL greater per hour (95% CI, 0.13–0.26). Among 379 patients with resection-multiplicity data, unadjusted endpoint frequencies were 14.5%, 38.3%, and 54.9% after no, one, and multiple full-thickness resections. Conclusions: Longer duration was associated with greater decline. Exploratory operative-extent gradients require prospective evaluation with standardized sampling before informing monitoring. Preoperative anemia remains relevant because the same decline produces a lower postoperative concentration.",
  "abstract_shown": true,
  "affiliations": [
    "Clinical Department of Gynecologic Oncology, Prof. Tadeusz Koszarowski Opole Cancer Centre, 66A Katowicka Street, 45-061 Opole, Poland",
    "Clinical Department of Gynecologic Oncology, Institute of Medical Sciences, University of Opole, 48 Oleska Street, 45-052 Opole, Poland",
    "J. Gromkowski Voivodship Specialist Hospital in Wroclaw, 5 Koszarowa Street, 51-149 Wroclaw, Poland"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Krzysztof Nowak",
      "orcid": "0000-0002-2230-9012"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Maja Mrugała",
      "orcid": "0000-0001-6305-9948"
    },
    {
      "affs": [
        2
      ],
      "name": "Weronika Ogonowska",
      "orcid": "0000-0001-5890-8415"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1ermm3knt63wp.bib",
  "cited_by": 0,
  "doi": "10.3390/jcm15208084",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706007/?tool=EBI",
  "id": "1ermm3knt63wp",
  "issns": [
    "2077-0383"
  ],
  "landing_url": "https://www.mdpi.com/2077-0383/15/20/8084",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2743|Endometriosis Research and Treatment"
    ]
  ],
  "openalex": "W7204122951",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13706007/pdf/?tool=EBI",
  "pmcid": "PMC13706007",
  "pmid": null,
  "published": "2026-10-01",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/1ermm3knt63wp.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:01Z",
      "native_id": "10.3390/jcm15208084",
      "source": "crossref",
      "url": "https://www.mdpi.com/2077-0383/15/20/8084"
    },
    {
      "first_seen": "2026-10-30T12:21:25Z",
      "native_id": "PMC:PMC13706007",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13706007"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2743|Endometriosis Research and Treatment",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Perioperative Hemoglobin Decline After Deep Endometriosis Surgery: Association with Surgery Duration and Exploratory Analyses of Operative Extent",
  "title_text": "Perioperative Hemoglobin Decline After Deep Endometriosis Surgery: Association with Surgery Duration and Exploratory Analyses of Operative Extent",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:25Z",
  "url": "https://research.draconitic.com/paper/1ermm3knt63wp",
  "venue": "Journal of Clinical Medicine",
  "versions": []
}