Goal-directed fluid therapy does not reduce postoperative ileus in gastrointestinal surgery

Zhang, Xiong-Xin; Zheng, Wei; Chen, Chaoqin; Kang, Xianhui; Zheng, Yan‐Song; Bao, Feichao; Gan, Shuyuan; Zhu, Shengmei

doi:10.1097/md.0000000000013097

Cited by 16 publications

(6 citation statements)

References 32 publications

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“…Study has reported that goal-directed uid therapy does not reduce postoperative ileus in gastrointestinal surgery. It is possible that uid overload is not necessary risk factor [13], which also proved our results about uid transfusion.…”

Section: Disccusionsupporting

confidence: 88%

Prognosis of Liver Transplantation: Does Postoperative Ileus Matter ?

Bai

Han

et al. 2020

Preprint

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Background: Nowadays, liver transplantation has become a main therapy for end-stage liver disease. However, studies show that there are high mortality and severe complications after liver transplantation. Although gastrointestinal dysfunction is a common and major complication among complications, there was rarely relative research. The study aims to elucidate the factors about ileus after liver transplantation and patients’ survival rate. Methods: We collected data (n=318, 2016–2019) from the First Affiliated Hospital of Xi’an Jiaotong University. After excluding cases, a total of 293 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. We reviewed 38 variables (including preoperative, operative and postoperative relative factors). In addition, other complications after liver transplantation and survival data were compared among groups. Results: Of the 293 patients, 23.2% (n=68) experienced postoperative ileus. Ileus patients were not different with non-ileus patients in preoperative, operative and postoperative factors. HBV-positive patients with ileus had a lower MELD score (P=0.025), and lower postoperative total bilirubin was correlated with ileus (P=0.049). Besides, Child-Pugh score of HCC patients with ileus was low (P=0.029). The complications after liver transplantation and survival rate were all not different among groups. Conclusions: According to our research, compared with non-ileus patients, we didn’t obtain the risk factors for patients with ileus. Ileus-patients didn’t increase complications after liver transplantation and didn’t decrease post-LT survival rates. But the preoperative MELD score and postoperative total bilirubin of HBV-positive patients with ileus were lower, and Child-Pugh score of HCC patients with ileus was also lower.

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Section: Disccusionsupporting

confidence: 88%

Prognosis of Liver Transplantation: Does Postoperative Ileus Matter ?

Bai

Han

et al. 2020

Preprint

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“…Study has reported that goal-directed fluid therapy does not reduce postoperative ileus in gastrointestinal surgery. It is possible that fluid overload is not necessary risk factor [ 13 ], which also been proved in our results. Besides, patients with POI had worse overall survival rates than patients without POI.…”

Section: Discussionsupporting

confidence: 77%

Prognosis of liver transplantation: Does postoperative ileus matter?

Bai

Han

et al. 2021

BMC Gastroenterol

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Background Nowadays, liver transplantation has become a main therapy for end-stage liver disease. However, studies show that there are high mortality and severe complications after liver transplantation. Although gastrointestinal dysfunction is a common and major complication after liver transplantation, there was rarely relative research. This study aims to elucidate the factors about ileus after liver transplantation and patients’ survival. Methods We collected and analyzed the data (n = 318, 2016–2019) from the First Affiliated Hospital of Xi’an Jiaotong University. After excluding cases, a total of 293 patients were included for this study. The subjects were divided into a non-ileus group and an ileus group. We reviewed 38 variables (including preoperative, operative and postoperative relative factors). Additionally, other complications after liver transplantation and survival data were compared between two groups. Results Of the 293 patients, 23.2% (n = 68) experienced postoperative ileus. Ileus patients were not different with non-ileus patients in preoperative, operative and postoperative factors. HBV-positive patients with ileus had a lower MELD score (P = 0.025), and lower postoperative total bilirubin was correlated with ileus (P = 0.049). Besides, Child–Pugh score of HCC patients with ileus was low (P = 0.029). The complications after liver transplantation were not different between two groups. Compared with the patients without ileus, the patients with ileus had a higher mortality rate. Conclusion According to our research, ileus-patients had a lower 1-year survival rates. The preoperative MELD score and postoperative total bilirubin of HBV-positive patients with ileus were lower, and Child–Pugh score of HCC patients with ileus was also lower.

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“…Both hypovolemia and hypervolemia can be detrimental to bowel function recovery. One meta-analysis summarized the data of 1,836 patients undergoing gastrointestinal surgery and concluded that GDFT did not reduce the incidence of ileus ( 18 ). In this study, GDFT did not show benefit in bowel function recovery, neither reducing the incidence of ileus nor advancing time of postoperative oral intake.…”

Section: Discussionmentioning

confidence: 99%

Goal-Directed Intraoperative Fluid Therapy Benefits Patients Undergoing Major Gynecologic Oncology Surgery: A Controlled Before-and-After Study

Che

Zhu

et al. 2022

Front. Oncol.

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BackgroundFluid management during major gynecologic oncology surgeries faces great challenges due to the distinctive characteristics of patients with gynecologic malignancies as well as features of the surgical procedure. Intraoperative goal-directed fluid therapy (GDFT) has been proven to be effective in reducing postoperative complications among major colorectal surgeries; however, the efficacy of GDFT has not been fully studied in gynecologic malignancy surgeries. This study aimed to discuss the influence of GDFT practice in patients undergoing major gynecologic oncology surgery.MethodsThis study was a controlled before-and-after study. From June 2015 to June 2018 in Peking Union Medical College Hospital, a total of 300 patients scheduled for elective laparotomy of gynecological malignancies were enrolled and chronologically allocated into two groups, with the earlier 150 patients in the control group and the latter 150 patients in the GDFT group. The GDFT protocol was applied by Vigileo/FloTrac monitoring of stroke volume and fluid responsiveness to guide intraoperative fluid infusion and the use of vasoactive agents. The primary outcome was postoperative complications within 30 days after surgery. The secondary outcome included length of stay and time of functional recovery.ResultsA total of 249 patients undergoing major gynecologic oncology surgery were analyzed in the study, with 129 in the control group and 120 patients in the GDFT group. Patients in the GDFT group had higher ASA classifications and more baseline comorbidities. GDFT patients received significantly less fluid infusion than the control group (15.8 vs. 17.9 ml/kg/h), while fluid loss was similar (6.9 vs. 7.1 ml/kg/h). GDFT was associated with decreased risk of postoperative complications (OR = 0.572, 95% CI 0.343 to 0.953, P = 0.032), especially surgical site infections (OR = 0.127, 95% CI 0.003 to 0.971, P = 0.037). The postoperative bowel function recovery and length of hospital stay were not significantly different between the two groups.ConclusionGoal-directed intraoperative fluid therapy is associated with fewer postoperative complications in patients undergoing major gynecologic oncology surgery.

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Goal-directed fluid therapy does not reduce postoperative ileus in gastrointestinal surgery

Abstract: Supplemental Digital Content is available in the text

Cited by 16 publications

References 32 publications

Prognosis of Liver Transplantation: Does Postoperative Ileus Matter ?

Prognosis of Liver Transplantation: Does Postoperative Ileus Matter ?

Prognosis of liver transplantation: Does postoperative ileus matter?

Goal-Directed Intraoperative Fluid Therapy Benefits Patients Undergoing Major Gynecologic Oncology Surgery: A Controlled Before-and-After Study

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