Erdogan-Ongel Elif, Coskun Nilufer, Meric Ayse Hilal, Goksoy Beslen, Bakan Nurten
Department of Anaesthesiology and Reanimation, Sancaktepe Martyr Prof. Dr. Ilhan Varank Education and Research Hospital, Istanbul, Turkey.
Department of General Surgery, Sancaktepe Martyr Prof. Dr. Ilhan Varank Education and Research Hospital, Istanbul, Turkey.
J Minim Access Surg. 2023 Apr-Jun;19(2):239-244. doi: 10.4103/jmas.jmas_19_22.
Intra-operative fluid management has been shown to significantly alter a patient's clinical condition in peri-operative care. Studies in the literature that investigated the effects of different amounts of intra-operative fluids on outcomes reported conflicting results.
To compare the post-operative results of intra-operative restrictive and conventional fluid administrations in laparoscopic colorectal cancer surgery.
All patients with ASA I, II and III, and those who had undergone laparoscopic colorectal cancer surgery were included. It was a retrospective, cohort study.
A review of laparoscopic colorectal cancer surgeries performed by the same fellow-trained colorectal surgeon with different anaesthesiologists between 1 January, 2018 and 30 November, 2021.
In total 80 patients were analysed; 2 patients were excluded, 28 patients were in restrictive (Group R) and 50 patients were in the conventional (Group C) group. The median age of all patients was 63 years and 74% were male. The median (interquartile ranges 25 to 75) intra-operative fluid administration was significantly different between groups; 3 ml/kg/h in Group R, and 7.2 ml/kg/h in Group C. (P < 0.001) Patients in Group C had significantly high post-operative intensive care unit admission (P < 0.05), and hospital length of stay (P = 0.005) compared to Group R.
Intra-operative fluid management was significantly associated with post-operative hospital length of stay and intensive care unit admission. Excessive intra-operative fluid management should be avoided in daily practice to improve the outcomes of laparoscopic colorectal cancer surgery.
术中液体管理已被证明在围手术期护理中会显著改变患者的临床状况。文献中研究不同术中液体量对结局影响的研究报告了相互矛盾的结果。
比较腹腔镜结直肠癌手术中术中限制性液体管理和传统液体管理的术后结果。
纳入所有ASA I、II和III级且接受过腹腔镜结直肠癌手术的患者。这是一项回顾性队列研究。
回顾了同一位接受过专科培训的结直肠外科医生在2018年1月1日至2021年11月30日期间与不同麻醉医生进行的腹腔镜结直肠癌手术。
共分析了80例患者；排除2例患者，28例患者为限制性补液组（R组），50例患者为传统补液组（C组）。所有患者的中位年龄为63岁，74%为男性。两组术中液体输注量的中位数（四分位数间距25至75）有显著差异；R组为3 ml/kg/h，C组为7.2 ml/kg/h。（P < 0.001）与R组相比，C组患者术后重症监护病房入住率显著更高（P < 0.05），住院时间也更长（P = 0.005）。
术中液体管理与术后住院时间和重症监护病房入住率显著相关。日常实践中应避免术中过度液体管理，以改善腹腔镜结直肠癌手术的结局。
