Roy Preety M, Bharti Kamal, Sinha Sudha, Khanna Sangeeta, Mehta Yatin
Department of Anaesthesia and Critical Care, Medanta The Medicity, Gurugram, Haryana, India.
J Anaesthesiol Clin Pharmacol. 2021 Jul-Sep;37(3):416-418. doi: 10.4103/joacp.JOACP_297_19. Epub 2021 Oct 12.
We aim to study the significance of intraoperative hyperlactatemia in reconstructive oncoplastic surgery.
A retrospective observational study was conducted on a cohort of patients who underwent reconstructive oncoplastic surgery with free flap for oral cancer over a 6-month period. The study population was divided into two groups based on peak lactate levels. Group N with peak lactate level less than 2 mmol/L and Group H peak lactate level more than 2 mmol/L. The various parameter studied were patient's comorbidities; intraoperative events (vasopressor requirement, blood transfusion, and duration of surgery); postoperative parameters including the need for re- exploration and duration of stay in hospital and intensive care unit.
The study demonstrates that intraoperative rise of lactate was not influenced by comorbidities. None of the intraoperative parameters studied influenced the lactate levels. Baseline lactate level was found to correlate with peak lactate level intraoperatively. But it was observed that there was normalization of lactate level within 24 hours postoperatively in both the groups. There was no difference in outcome parameters in the two groups.
Intraoperative hyperlactatemia is not a significant prognostic factor for outcome in oncoplastic reconstructive surgery.
我们旨在研究术中高乳酸血症在肿瘤整形重建手术中的意义。
对一组在6个月期间接受口腔癌游离皮瓣肿瘤整形重建手术的患者进行了一项回顾性观察研究。根据乳酸峰值水平将研究人群分为两组。乳酸峰值水平低于2 mmol/L的N组和乳酸峰值水平高于2 mmol/L的H组。研究的各种参数包括患者的合并症；术中事件（血管升压药需求、输血和手术持续时间）；术后参数，包括再次探查的必要性以及在医院和重症监护病房的住院时间。
研究表明，术中乳酸升高不受合并症影响。所研究的术中参数均未影响乳酸水平。发现基线乳酸水平与术中乳酸峰值水平相关。但观察到两组术后24小时内乳酸水平均恢复正常。两组的结局参数没有差异。
术中高乳酸血症不是肿瘤整形重建手术结局的重要预后因素。
