Influence of intraoperative fluid volume on pulmonary complications in patients undergoing minimally invasive endoscopic esophagectomy
- VernacularTitle:术中液体输注量对微创腔镜食管切除术后肺部并发症的影响
- Author:
Ying CHEN
1
;
Kaixi SHANG
2
,
3
;
Wei TIAN
4
,
5
;
Qirong SUN
6
;
Hai YU
6
Author Information
1. 1. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China；2. Department of Anesthesiology, Liangshan Prefecture Hospital of Integrated Traditional Chinese and Western Medicine, Xichang, 615000, Sichuan, P. R. China
2. Department of Anesthesiology, Chengdu Office Hospital of the People'
3. s Government of Tibet Autonomous Region, Chengdu, 610041, P. R. China
4. Department of Anesthesiology, Neijiang People'
5. s Hospital, Neijiang, 641400, Sichuan, P. R. China
6. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, 610041, P. R. China
- Publication Type:Journal Article
- Keywords:
Intraoperative fluid infusion volume;
minimally invasive surgery for esophageal cancer;
postoperative pulmonary complications
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2022;29(06):717-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of intraoperative fluid infusion volume on postoperative pulmonary complications (PPCs) in patients after minimally invasive endoscopic esophageal carcinoma resection. Methods From June 2019 to August 2021, 486 patients undergoing elective minimally invasive endoscopic esophagectomy for esophageal cancer were retrospectively screened from the electronic medical record information management system and anesthesia surgery clinical information system of West China Hospital of Sichuan University. There were 381 males and 105 females, with a median age of 64.0 years. Taking the incidence of pulmonary complications within 7 days after operation as the primary outcome, the correlation between intraoperative fluid infusion volume and the occurrence of PPCs within 7 days was clearly analyzed by regression analysis. Results The incidence of pulmonary complications within 7 days after surgery was 33.5% (163/486). Regression analysis showed that intraoperative fluid infusion volume was correlated with the occurrence of PPCs [adjusted OR=1.089, 95%CI (1.012, 1.172), P=0.023], especially pulmonary infection [adjusted OR=1.093, 95%CI (1.014, 1.178), P=0.020], and pleural effusion [adjusted OR=1.147, 95%CI (1.007, 1.306), P=0.039]. Pulmonary infection was significantly less in the low intraoperative fluid infusion group [<6.49 mL/(kg·h), n=115] compared with the high intraoperative fluid infusion group [≥6.49 mL/(kg·h), n=371] (18.3% vs. 34.5%, P=0.023). Intraoperative fluid infusion volume was positively associated with death within 30 days after surgery [adjusted OR=1.442, 95%CI (1.056, 1.968), P=0.021]. Conclusion Among patients undergoing elective minimally invasive endoscopic esophageal cancer resection, intraoperative fluid infusion volume is related with the occurrence of PPCs within 7 days after the surgery, especially pulmonary infection and pleural effusion, and may affect death within 30 days after the surgery.
