Effect of intraoperative fluid management on prolonged postoperative ileus after colorectal surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

SUN Qirong ,  YU Hai

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

YU Hai, Email: yuhaishan117@yahoo.com

Keywords：

prolonged postoperative ileus; intraoperative fluid management; colorectal surgery

DOI：

10.7507/1007-9424.202006059

Video：

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Objective To evaluate the association between intraoperative fluid management and prolonged postoperative ileus (PPOI) after colorectal surgery. Methods We reviewed the data of 980 patients who underwent elective colorectal surgery in West China Hospital of Sichuan University between July and December 2016. The primary outcome was PPOI. The association of intraoperative fluid volume and fluid balance with PPOI were analyzed. Results Nine hundred and eighty patients undergoing elective colorectal surgery were included, and the incidence of PPOI was 31.1% (305/980). Compared with non-PPOI patients, patients with PPOI had longer postoperative hospital stay and increased total hospital cost (P<0.05). Multivariate logistic regression analysis did not find intraoperative fluid volume and fluid balance were associated with PPOI in patients undergoing colorectal surgery (P>0.05). Conclusions There is no clinically relevant association between intraoperative fluid management and PPOI in adult patients underwent colorectal surgery. However, the occurrence of PPOI may prolong postoperative hospital stay and increase hospitalization cost.

Citation： SUN Qirong, YU Hai. Effect of intraoperative fluid management on prolonged postoperative ileus after colorectal surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2020, 27(9): 1100-1106. doi: 10.7507/1007-9424.202006059 Copy

1.	Chapuis PH, Bokey L, Keshava A, et al. Risk factors for prolonged ileus after resection of colorectal cancer: an observational study of2 400 consecutive patients. Ann Surg, 2013, 257(5): 909-915.
2.	Moghadamyeghaneh Z, Hwang GS, Hanna MH, et al. Risk factors for prolonged ileus following colon surgery. Surg Endosc, 2016, 30(2): 603-609.
3.	Vather R, Josephson R, Jaung R, et al. Development of a risk stratification system for the occurrence of prolonged postoperative ileus after colorectal surgery: a prospective risk factor analysis. Surgery, 2015, 157(4): 764-773.
4.	Greco M, Capretti G, Beretta L, et al. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg, 2014, 38(6): 1531-1541.
5.	Tiernan JP, Liska D. Enhanced recovery after surgery: recent developments in colorectal surgery. Surg Clin North Am, 2018, 98(6): 1241-1249.
6.	Jia FJ, Yan QY, Sun Q, et al. Liberal versus restrictive fluid management in abdominal surgery: a meta-analysis. Surg Today, 2017, 47(3): 344-356.
7.	Thacker JK, Mountford WK, Ernst FR, et al. Perioperative fluid utilization variability and association with outcomes: considerations for enhanced recovery efforts in sample US surgical populations. Ann Surg, 2016, 263(3): 502-510.
8.	Shin CH, Long DR, McLean D, et al. Effects of intraoperative fluid management on postoperative outcomes: a hospital registry study. Ann Surg, 2018, 267(6): 1084-1092.
9.	von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg, 2014, 12(12): 1495-1499.
10.	WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 2004, 363(9403): 157-163.
11.	Myles PS, Bellomo R, Corcoran T, et al. Restrictive versus liberal fluid therapy for major abdominal surgery. N Engl J Med, 2018, 378(24): 2263-2274.
12.	Regenbogen SE, Shah NJ, Collins SD, et al. Population-based assessment of intraoperative fluid administration practices across three surgical specialties. Ann Surg, 2017, 265(5): 930-940.
13.	Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg, 2013, 17(5): 962-972.
14.	Sugawara K, Kawaguchi Y, Nomura Y, et al. Perioperative factors predicting prolonged postoperative ileus after major abdominal surgery. J Gastrointest Surg, 2018, 22(3): 508-515.
15.	Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol, 2015, 32(2): 88-105.
16.	Venara A, Neunlist M, Slim K, et al. Postoperative ileus: pathophysiology, incidence, and prevention. J Visc Surg, 2016, 153(6): 439-446.
17.	Quiroga-Centeno AC, Jerez-Torra KA, Martin-Mojica PA, et al. Risk factors for prolonged postoperative ileus in colorectal surgery: a systematic review and meta-analysis. World J Surg, 2020, 44(5): 1612-1626.
18.	Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS ®) society recommendations: 2018. World J Surg, 2019, 43(3): 659-695.
19.	Rybakov EG, Shelygin YA, Khomyakov EA, et al. Risk factors for postoperative ileus after colorectal cancer surgery. Colorectal Dis, 2017, 16(20): 189-194.
20.	Gan TJ, Robinson SB, Oderda GM, et al. Impact of postsurgical opioid use and ileus on economic outcomes in gastrointestinal surgeries. Curr Med Res Opin, 2015, 31(4): 677-686.
21.	Ceretti AP, Maroni N, Longhi M, et al. Risk factors for prolonged postoperative ileus in adult patients undergoing elective colorectal surgery: an observational cohort study. Rev Recent Clin Trials, 2018, 13(4): 295-304.
22.	Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth, 2002, 89(4): 622-632.
23.	Grass F, Pache B, Butti F, et al. Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure. Langenbecks Arch Surg, 2019, 404(1): 39-43.
24.	Grass F, Lovely JK, Crippa J, et al. Potential association between perioperative fluid management and occurrence of postoperative ileus. Dis Colon Rectum, 2020, 63(1): 68-74.
25.	VandeHei MS, Papageorge CM, Murphy MM, et al. The effect of perioperative fluid management on postoperative ileus in rectal cancer patients. Surgery, 2017, 161(6): 1628-1632.
26.	Wu Y, Yang R, Xu J, et al. Effects of intraoperative fluid management on postoperative outcomes after lobectomy. Ann Thorac Surg, 2019, 107(6): 1663-1669.

1. Chapuis PH, Bokey L, Keshava A, et al. Risk factors for prolonged ileus after resection of colorectal cancer: an observational study of2 400 consecutive patients. Ann Surg, 2013, 257(5): 909-915.
2. Moghadamyeghaneh Z, Hwang GS, Hanna MH, et al. Risk factors for prolonged ileus following colon surgery. Surg Endosc, 2016, 30(2): 603-609.
3. Vather R, Josephson R, Jaung R, et al. Development of a risk stratification system for the occurrence of prolonged postoperative ileus after colorectal surgery: a prospective risk factor analysis. Surgery, 2015, 157(4): 764-773.
4. Greco M, Capretti G, Beretta L, et al. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World J Surg, 2014, 38(6): 1531-1541.
5. Tiernan JP, Liska D. Enhanced recovery after surgery: recent developments in colorectal surgery. Surg Clin North Am, 2018, 98(6): 1241-1249.
6. Jia FJ, Yan QY, Sun Q, et al. Liberal versus restrictive fluid management in abdominal surgery: a meta-analysis. Surg Today, 2017, 47(3): 344-356.
7. Thacker JK, Mountford WK, Ernst FR, et al. Perioperative fluid utilization variability and association with outcomes: considerations for enhanced recovery efforts in sample US surgical populations. Ann Surg, 2016, 263(3): 502-510.
8. Shin CH, Long DR, McLean D, et al. Effects of intraoperative fluid management on postoperative outcomes: a hospital registry study. Ann Surg, 2018, 267(6): 1084-1092.
9. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg, 2014, 12(12): 1495-1499.
10. WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 2004, 363(9403): 157-163.
11. Myles PS, Bellomo R, Corcoran T, et al. Restrictive versus liberal fluid therapy for major abdominal surgery. N Engl J Med, 2018, 378(24): 2263-2274.
12. Regenbogen SE, Shah NJ, Collins SD, et al. Population-based assessment of intraoperative fluid administration practices across three surgical specialties. Ann Surg, 2017, 265(5): 930-940.
13. Vather R, Trivedi S, Bissett I. Defining postoperative ileus: results of a systematic review and global survey. J Gastrointest Surg, 2013, 17(5): 962-972.
14. Sugawara K, Kawaguchi Y, Nomura Y, et al. Perioperative factors predicting prolonged postoperative ileus after major abdominal surgery. J Gastrointest Surg, 2018, 22(3): 508-515.
15. Jammer I, Wickboldt N, Sander M, et al. Standards for definitions and use of outcome measures for clinical effectiveness research in perioperative medicine: European Perioperative Clinical Outcome (EPCO) definitions: a statement from the ESA-ESICM joint taskforce on perioperative outcome measures. Eur J Anaesthesiol, 2015, 32(2): 88-105.
16. Venara A, Neunlist M, Slim K, et al. Postoperative ileus: pathophysiology, incidence, and prevention. J Visc Surg, 2016, 153(6): 439-446.
17. Quiroga-Centeno AC, Jerez-Torra KA, Martin-Mojica PA, et al. Risk factors for prolonged postoperative ileus in colorectal surgery: a systematic review and meta-analysis. World J Surg, 2020, 44(5): 1612-1626.
18. Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS ®) society recommendations: 2018. World J Surg, 2019, 43(3): 659-695.
19. Rybakov EG, Shelygin YA, Khomyakov EA, et al. Risk factors for postoperative ileus after colorectal cancer surgery. Colorectal Dis, 2017, 16(20): 189-194.
20. Gan TJ, Robinson SB, Oderda GM, et al. Impact of postsurgical opioid use and ileus on economic outcomes in gastrointestinal surgeries. Curr Med Res Opin, 2015, 31(4): 677-686.
21. Ceretti AP, Maroni N, Longhi M, et al. Risk factors for prolonged postoperative ileus in adult patients undergoing elective colorectal surgery: an observational cohort study. Rev Recent Clin Trials, 2018, 13(4): 295-304.
22. Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth, 2002, 89(4): 622-632.
23. Grass F, Pache B, Butti F, et al. Stringent fluid management might help to prevent postoperative ileus after loop ileostomy closure. Langenbecks Arch Surg, 2019, 404(1): 39-43.
24. Grass F, Lovely JK, Crippa J, et al. Potential association between perioperative fluid management and occurrence of postoperative ileus. Dis Colon Rectum, 2020, 63(1): 68-74.
25. VandeHei MS, Papageorge CM, Murphy MM, et al. The effect of perioperative fluid management on postoperative ileus in rectal cancer patients. Surgery, 2017, 161(6): 1628-1632.
26. Wu Y, Yang R, Xu J, et al. Effects of intraoperative fluid management on postoperative outcomes after lobectomy. Ann Thorac Surg, 2019, 107(6): 1663-1669.

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Effect of intraoperative fluid management on prolonged postoperative ileus after colorectal surgery

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