Association of Perioperative Fluid Balance and Adverse Surgical Outcomes in Esophageal Cancer and Esophagogastric Junction Cancer

Anaesthesia during oesophagectomy

“…However, it remains unclear whether a reduction in anastomotic leakage can be achieved by fluid restriction as surgical and anatomical factors may play a more important etiologic role. This can also be concluded from the data of Wei et al (45). A relationship between fluid balance and anastomotic leakage was not found.…”

“…Fluid management in this patient group has until recently focused on restricting fluid administration to prevent pulmonary and cardiac complications (40). The majority of studies focus on patients after lung surgery and only a few small retrospective studies are available on oesophageal surgery showing a reduction in pulmonary complications with fluid restriction (45,46). However, it remains unclear whether a reduction in anastomotic leakage can be achieved by fluid restriction as surgical and anatomical factors may play a more important etiologic role.…”

Fluid and electrolyte balance after major thoracic surgery by bioimpedance and endocrine evaluation

“…The acute stress response to major surgery can determine a severe inflammatory response syndrome and profound changes in the endocrine, neuroendocrine and immune system responses, as well as significant changes in organ function [16,17], leading to fluid retention [6,17,18]. Taken together, the net effect is an increased catabolism with increased substrate availability for energy production, and sodium and water retention to maintain fluid volume and haemodynamic stability [6,17].…”

Are lung-protective ventilation strategies worth the effort?

“…89,90 In addition to the potential importance of the amount and timing of fluid administration, there is some clinical evidence that the choice of fluid type may be important in affecting clinical outcomes. 91 Intravascular colloid retention during the treatment of hypovolaemia may approach 90% vs. 40% when administered during normovolaemia. 92 The relationship of hydrostatic and oncotic pressure to determine fluid flux across a semi-permeable membrane was described in a classic equation that was developed by Starling in 1896.…”