Effect of intraoperative fluid volume on postoperative ileus after robot-assisted radical cystectomy

Abstract

This study aimed to investigate the effect of intraoperative fluid volume on the postoperative ileus (POI) recovery period. A retrospective review of the Korean robot-assisted radical cystectomy database identified 718 patients who underwent robot-assisted radical cystectomy (RARC). Regression analyses were performed to identify the associations between the amount of intraoperative fluid administration (crystalloid/colloid/total), POI period (time to flatus/bowel movements), and length of hospital stay (LOS) after adjusting for covariates. In addition, we analyzed the risk factors for gastrointestinal complications and prolonged POI using a logistic regression model. An increasing volume of the administered crystalloid/total fluid was associated with prolonged POI (crystalloid R2 = 0.0725 and P < 0.0001; total amount R2 = 0.0812 and P < 0.0001), and the total fluid volume was positively associated with the LOS (R2 = 0.099 and P < 0.0001). The crystalloid amount was a risk factor for prolonged POI (P < 0.001; odds ratio, 1.361; 95% confidence interval, 1.133–1.641; P < 0.001). In the context of RARC, increased intravenous fluids are associated with prolonged POI and longer LOS.

Macroscopically entangled light fields

“…1 a acts as a quantum device whether the input field is a single photon or coherent light. As already discussed, anticorrelation in a HOM dip naturally satisfies the phase basis relation in a particular system 26 , 29 . For a BS, the phase bases for anticorrelation are , while for an MZI, it is 0 and .…”

“…Here, it should be noted that the conventional understanding of classicality for the individuality of coupled photons has been discussed in Bell’s inequality theorem 2 . In that sense, coherence optics may or may not belong to classical physics depending on the phase choice, as discussed for anticorrelation 26 , 29 .

Figure 1 Schematic of macroscopic entangled field generation.

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“…( 6 ) may result in dephasing-caused partial washout of the effect in . Unlike the SPDC case with random phases among entangled photon pairs due to the intrinsic frequency detuning swapping 29 , the bandwidth-caused dephasing in Eq. ( 6 ) is far less sensitive to dephasing.…”

“…( 8 ) and ( 9 ) have no effect on the symmetric phase shift of , resulting in regardless of . This is equivalent to random swapping of symmetric frequency detuning in the SPDC-generated photon pairs 29 . Thus, and impinging on a BS exhibit macroscopic quantum features, similar to a HOM dip with entangled photon pairs as derived in Eq.…”

“…Recently, the fundamental physics of quantumness or nonclassicality has been investigated for a HOM dip 26 , photonic de Broglie wavelength 27 , and Franson-type nonlocal correlation 28 using the wave nature of photons, where the origin of anticorrelation in a HOM dip is rooted in a phase shift between the entangled photons 26 , 29 . The origin of nonlocal correlation has been discovered in the basis randomness for a coupled bipartite system via quantum superposition 30 .…”