Introduction Cancellations of elective surgery in low-and middle-income countries (LMIC) are common and a major hindrance for patients who are in need of this therapeutic modality. There is a knowledge gap in the literature related to cancellation of gynecologic oncology surgeries due specifically to lack of blood products. Herein we report our experience at the University Teaching Hospital (UTH) and Cancer Diseases Hospital (CDH) in Lusaka, Zambia.

Methods From January 1 through December 31, 2021, we retrospectively evaluated the surgical registry for gynecologic oncology at UTH) and (CDH) to assess the number and causes of surgical cancellations with focus on lack of blood availability and/or low hemoglobin. A hemoglobin value of 10 mg/dL or more, coupled with availability of blood for possible peri-operatively transfusion were considered minimum requirements for performing major gynaecologic oncology surgeries.

Results There were a total of 24 (16.4%) surgical cancellations out of 146 scheduled gynecologic oncology cases. Table 1 Lack of available blood and/or low hemoglobin was the most frequent cause of surgical cancelations 11 cases (45.8%). Table 2 Cancelled cases and their diagnosis are listed. Table 3

Conclusion/Implications As gynecologic oncology services scale up in LMIC, given the blood loss associated with these extensive cancer surgeries and the limited availability of radiation and chemotherapy; it is important to address and understand the need to have available blood on the scheduled date of surgery to prevent treatment delays.