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机器人辅助根治性膀胱切除术后术中液体量对术后肠梗阻的影响。

Effect of intraoperative fluid volume on postoperative ileus after robot-assisted radical cystectomy.

机构信息

Department of Urology, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea.

Department of Urology, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Sci Rep. 2021 May 18;11(1):10522. doi: 10.1038/s41598-021-89806-z.

Abstract

This study aimed to investigate the effect of intraoperative fluid volume on the postoperative ileus (POI) recovery period. A retrospective review of the Korean robot-assisted radical cystectomy database identified 718 patients who underwent robot-assisted radical cystectomy (RARC). Regression analyses were performed to identify the associations between the amount of intraoperative fluid administration (crystalloid/colloid/total), POI period (time to flatus/bowel movements), and length of hospital stay (LOS) after adjusting for covariates. In addition, we analyzed the risk factors for gastrointestinal complications and prolonged POI using a logistic regression model. An increasing volume of the administered crystalloid/total fluid was associated with prolonged POI (crystalloid R = 0.0725 and P < 0.0001; total amount R = 0.0812 and P < 0.0001), and the total fluid volume was positively associated with the LOS (R = 0.099 and P < 0.0001). The crystalloid amount was a risk factor for prolonged POI (P < 0.001; odds ratio, 1.361; 95% confidence interval, 1.133-1.641; P < 0.001). In the context of RARC, increased intravenous fluids are associated with prolonged POI and longer LOS.

摘要

本研究旨在探讨术中液体量对术后肠梗阻(POI)恢复时间的影响。对韩国机器人辅助根治性膀胱切除术数据库进行回顾性分析,共纳入 718 例接受机器人辅助根治性膀胱切除术(RARC)的患者。通过回归分析,确定术中液体输注量(晶体液/胶体液/总量)与 POI 期(排气/排便时间)和住院时间(LOS)之间的关联,同时调整了协变量。此外,还使用逻辑回归模型分析了胃肠道并发症和 POI 延长的危险因素。晶体液/总液的输注量与 POI 延长呈正相关(晶体液 R=0.0725,P<0.0001;总液量 R=0.0812,P<0.0001),总液体量与 LOS 呈正相关(R=0.099,P<0.0001)。晶体液量是 POI 延长的危险因素(P<0.001;优势比,1.361;95%置信区间,1.133-1.641;P<0.001)。在 RARC 中,静脉补液量增加与 POI 延长和 LOS 延长相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6799/8131600/864746d7d6f6/41598_2021_89806_Fig1_HTML.jpg

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