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The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis

OBJECTIVE: Transthoracic esophagectomy is associated with significant morbidity and mortality. Therefore, it is imperative to optimize perioperative management and minimize complications. In this retrospective analysis, we evaluated the association between fluid balance and esophagectomy complicatio...

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Autores principales: Buchholz, Vered, Hazard, Riley, Yin, Zoe, Tran, Nghiep, Yip, Sui Wah Sean, Le, Peter, Kioussis, Benjamin, Hinton, Jake, Liu, David S, Lee, Dong-Kyu, Weinberg, Laurence
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629189/
https://www.ncbi.nlm.nih.gov/pubmed/37932807
http://dx.doi.org/10.1186/s13104-023-06574-x
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author Buchholz, Vered
Hazard, Riley
Yin, Zoe
Tran, Nghiep
Yip, Sui Wah Sean
Le, Peter
Kioussis, Benjamin
Hinton, Jake
Liu, David S
Lee, Dong-Kyu
Weinberg, Laurence
author_facet Buchholz, Vered
Hazard, Riley
Yin, Zoe
Tran, Nghiep
Yip, Sui Wah Sean
Le, Peter
Kioussis, Benjamin
Hinton, Jake
Liu, David S
Lee, Dong-Kyu
Weinberg, Laurence
author_sort Buchholz, Vered
collection PubMed
description OBJECTIVE: Transthoracic esophagectomy is associated with significant morbidity and mortality. Therefore, it is imperative to optimize perioperative management and minimize complications. In this retrospective analysis, we evaluated the association between fluid balance and esophagectomy complications at a tertiary hospital in Melbourne, Australia, with a particular focus on respiratory morbidity and anastomotic leaks. Cumulative fluid balance was calculated intraoperatively, postoperatively in recovery postoperative day (POD) 0, and on POD 1 and 2. High and low fluid balance was defined as greater than or less than the median fluid balance, respectively, and postoperative surgical complications were graded using the Clavien-Dindo classification. RESULTS: In total, 109 patients, with an average age of 64 years, were included in this study. High fluid balance on POD 0, POD1 and POD 2 was associated with a higher incidence of anastomotic leak (OR 8.59; 95%CI: 2.64-39.0). High fluid balance on POD 2 was associated with more severe complications (of any type) (OR 3.33; 95%CI: 1.4–8.26) and severe pulmonary complications (OR 3.04; 95%CI: 1.27–7.67). For every 1 L extra cumulative fluid balance in POD 1, the odds of a major complication increase by 15%, while controlling for body mass index (BMI) and American Society of Anaesthesiologists (ASA) class. The results show that higher cumulative fluid balance is associated with worsening postoperative outcomes in patients undergoing transthoracic esophagectomy. Restricted fluid balance, especially postoperatively, may mitigate the risk of postoperative complications – however prospective trials are required to establish this definitively. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13104-023-06574-x.
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spelling pubmed-106291892023-11-08 The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis Buchholz, Vered Hazard, Riley Yin, Zoe Tran, Nghiep Yip, Sui Wah Sean Le, Peter Kioussis, Benjamin Hinton, Jake Liu, David S Lee, Dong-Kyu Weinberg, Laurence BMC Res Notes Research Note OBJECTIVE: Transthoracic esophagectomy is associated with significant morbidity and mortality. Therefore, it is imperative to optimize perioperative management and minimize complications. In this retrospective analysis, we evaluated the association between fluid balance and esophagectomy complications at a tertiary hospital in Melbourne, Australia, with a particular focus on respiratory morbidity and anastomotic leaks. Cumulative fluid balance was calculated intraoperatively, postoperatively in recovery postoperative day (POD) 0, and on POD 1 and 2. High and low fluid balance was defined as greater than or less than the median fluid balance, respectively, and postoperative surgical complications were graded using the Clavien-Dindo classification. RESULTS: In total, 109 patients, with an average age of 64 years, were included in this study. High fluid balance on POD 0, POD1 and POD 2 was associated with a higher incidence of anastomotic leak (OR 8.59; 95%CI: 2.64-39.0). High fluid balance on POD 2 was associated with more severe complications (of any type) (OR 3.33; 95%CI: 1.4–8.26) and severe pulmonary complications (OR 3.04; 95%CI: 1.27–7.67). For every 1 L extra cumulative fluid balance in POD 1, the odds of a major complication increase by 15%, while controlling for body mass index (BMI) and American Society of Anaesthesiologists (ASA) class. The results show that higher cumulative fluid balance is associated with worsening postoperative outcomes in patients undergoing transthoracic esophagectomy. Restricted fluid balance, especially postoperatively, may mitigate the risk of postoperative complications – however prospective trials are required to establish this definitively. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13104-023-06574-x. BioMed Central 2023-11-06 /pmc/articles/PMC10629189/ /pubmed/37932807 http://dx.doi.org/10.1186/s13104-023-06574-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Note
Buchholz, Vered
Hazard, Riley
Yin, Zoe
Tran, Nghiep
Yip, Sui Wah Sean
Le, Peter
Kioussis, Benjamin
Hinton, Jake
Liu, David S
Lee, Dong-Kyu
Weinberg, Laurence
The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title_full The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title_fullStr The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title_full_unstemmed The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title_short The impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
title_sort impact of intraoperative and postoperative fluid balance on complications for transthoracic esophagectomy: a retrospective analysis
topic Research Note
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10629189/
https://www.ncbi.nlm.nih.gov/pubmed/37932807
http://dx.doi.org/10.1186/s13104-023-06574-x
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