Anesthesia and perioperative management of colorectal surgical patients - specific issues (part 2)

Patel, Santosh; Lutz, Jan Markus; Panchagnula, U.; Bansal, Sujesh

doi:10.4103/0970-9185.98321

Cited by 9 publications

(7 citation statements)

References 80 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, excessive intraoperative fluid administration also leads to poor outcomes, including increased postoperative bowel edema, respiratory complications, and longer durations of hospital stay. Therefore, goal-directed fluid supply is warranted since optimal intraoperative supply of fluids improves postoperative recovery and prognosis [ 1 , 2 , 3 ]. Unfortunately, optimal fluid replacement therapy during major abdominal surgery remains unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Inadequate fluid management may cause delayed GI function recovery and may thus prevent early oral intake. Moreover, postoperative GI dysfunction may cause electrolyte loss and metabolic problems [ 3 ]. For precise measurement of adequate intravascular volume, central venous pressure, pulmonary artery occlusion pressure, the intrathoracic blood volume index, and the left ventricular end-diastolic volume index were introduced; however, these often fail to provide reliable information or to predict fluid responsiveness and often provide conflicting reports [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery

Lee

Yoo

Cho

et al. 2021

JCM

View full text Add to dashboard Cite

Stroke volume variation (SVV) has been used to predict fluid responsiveness; however, it remains unclear whether goal-directed fluid therapy using SVV contributes to bowel function recovery in abdominal surgery. This prospective randomized controlled trial aimed to compare bowel movement recovery in patients undergoing colon resection surgery between groups using traditional or SVV-based methods for intravenous fluid management. We collected data between March 2015 and July 2017. Bowel function recovery was analyzed based on the gas-passing time, sips of water time, and soft diet (SD) time. Finally, we analyzed data from 60 patients. There was no significant between-group difference in the patients’ characteristics. Compared with the control group (n = 30), the SVV group (n = 30) had a significantly higher colloid volume and lower crystalloid volume. Moreover, the gas-passing time (77.8 vs. 85.3 h, p = 0.034) and SD time (67.6 vs. 85.1 h, p < 0.001) were significantly faster in the SVV group than in the control group. Compared with the control group, the SVV group showed significantly lower scores of pain on a numeric rating scale and morphine equivalent doses during post-anesthetic care, at 24 postoperative hours, and at 48 postoperative hours. Our findings suggested that, compared with the control group, the SVV group showed a faster postoperative SD time, reduced acute postoperative pain intensity, and lower rescue analgesics. Therefore, SVV-based optimal fluid management is expected to potentially contribute to postoperative bowel function recovery in patients undergoing colon resection surgery.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery

Lee

Yoo

Cho

et al. 2021

JCM

View full text Add to dashboard Cite

show abstract

“…If fluid therapy is not optimal, it may cause delayed gastrointestinal function and avoid early oral intake. If gastrointestinal dysfunction develops in the perioperative period, it may lead to fluid and electrolyte loss and metabolic problems [ 6 ]. Thus, the intraoperative fluid management of the patient is very important.…”

Section: Introductionmentioning

confidence: 99%

Comparison of conventional fluid management with PVI-based goal-directed fluid management in elective colorectal surgery

Cesur

Çardaközü

Kuş

et al. 2018

J Clin Monit Comput

View full text Add to dashboard Cite

Intraoperative fluid management is quite important in terms of postoperative organ perfusion and complications. Different fluid management protocols are in use for this purpose. Our primary goal was to compare the effects of conventional fluid management (CFM) with the Pleth Variability Index (PVI) guided goal-directed fluid management (GDFM) protocols on the amount of crystalloids administered, blood lactate, and serum creatinine levels during the intraoperative period. The length of hospital stay was our secondary goal. Seventy ASA I-II elective colorectal surgery patients were randomly assigned to CFM or GDFM for fluid management. The hemodynamic data and the data obtained from ABG were recorded at the end of induction and during the follow-up period at 1 h intervals. In the preoperative period and at 24 h postoperatively, blood samples were taken for the measurement of hemoglobin, Na, K, Cl, serum creatinine, albumin and blood lactate. In the first 24 h after surgery, oliguria and the time of first bowel movement were recorded. Length of hospital stay was also recorded. Intraoperative crystalloid administration and urine output were statistically significantly higher in CFM group (p < 0.001, p: 0.018). The end-surgery fluid balance was significantly lower in Group GDFM. Preoperative and postoperative Na, K, Cl, serum albumin, serum creatinine, lactate and hemoglobin values were similar between the groups. The time to passage of stool was significantly short in Group-GDFM compared to Group-CFM (p = 0.016). The length of hospital stay was found to be similar in both group. PVI-guided GDFM might be an alternative to CFM in ASA I-II patients undergoing elective colorectal surgery. However, further studies need to be carried out to search the efficiency and safety of PVI.

show abstract

“…12 patients experienced medical complications. The management of colorectal surgical patients requires me-ticulous fluid and electrolyte therapy, and the involvement of a multidisciplinary team comprehensive of anesthesiologist for the understanding of the pre-existing comorbidities that are involved in the morbidity of the patients [12]. Age was non-related with the morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Morbidity and Mortality after Colorectal Surgery for Cancer

Angelucci¹,

Sinibaldi²,

Orsaria³

et al. 2013

View full text Add to dashboard Cite

Colorectal Cancer is the second most common cancer in western countries and, currently, surgical resection is still the principal treatment for this pathology. However, the operation carries significant morbidity and mortality, which is associated with an enormous use of healthcare resources. The aim of our study is to evaluate the incidence and the management of complications, and to understand how pre-exisiting comorbidities can influence the recovery of the patients. Between 2007 and 2012, a total of 534 patients underwent elective or emergency surgery for colorectal cancer in our department. Patients were identified for this study from a prospectively entered computerized database. Case notes of patients documented comorbidities, type of surgery performed, complication in the early postoperative period (30 days after surgery) and the management. Postoperative morbidity affected 89 patients (17%), of these 25 (27%) were anastomotic leakage (AL). 22 (24%) patients experienced intra-abdominal abscess. 16 patients (17%) had wound infections. 11 patients (13%) experienced post-operative bleeding and five of them had a re-operation within the I and the II day after surgery. 12 (13%) complained medical (cardiologic/respiratory) complications. We had 1 (1%) Small Bowel Obstruction, treated with a conservative therapy. Reoperation rate was 3% with 11 for AL, and 5 for bleeding. The mortality rate was 0.55% (3 patients). In our experience, we evidenced that surgery performed for advanced rectal cancer in the lower rectum, especially in urgency settings is associated with an increase of morbidity and mortality in the early post-operative period. Pre-existing comorbidities are involved in the morbidity of the patients, and a more accurate approach both in surgical technique and in the post-operative management can be proposed to the surgeon. Derivative stoma in high risk patients gave us the possibility of a conservative treatment of the Anastomotic Leak, the most common complication in our study, with antibiotics and CT-drainage.

show abstract

Anesthesia and perioperative management of colorectal surgical patients - specific issues (part 2)

Cited by 9 publications

References 80 publications

The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery

The Effect of Intraoperative Fluid Management According to Stroke Volume Variation on Postoperative Bowel Function Recovery in Colorectal Cancer Surgery

Comparison of conventional fluid management with PVI-based goal-directed fluid management in elective colorectal surgery

Morbidity and Mortality after Colorectal Surgery for Cancer

Contact Info

Product

Resources

About