In:
Frontiers in Surgery, Frontiers Media SA, Vol. 8 ( 2021-12-6)
Abstract:
Study Objective: This study aimed to investigate whether stroke volume variation (SVV)-guided goal-directed therapy (GDT) can improve postoperative outcomes in elderly patients undergoing minimally invasive esophagectomy (MIE) compared with conventional care. Design: A prospective, randomized, controlled study. Setting: A single tertiary care center with a study period from November 2017 to December 2018. Patients: Patients over 65 years old who were scheduled for elective MIE. Interventions: The GDT protocol included a baseline fluid supplement of 7 ml/kg/h Ringer's lactate solution and SVV optimization using colloid boluses assessed by pulse-contour analysis (PiCCO™). When SVV exceeded 11%, colloid was infused at a rate of 50 ml per minute; if SVV returned below 9% for at least 2 minutes, then colloid was stopped. Measurements: The primary outcome was the incidence of postoperative complications before discharge, as assessed using a predefined list, including postoperative anastomotic leakage, postoperative hoarseness, postoperative pulmonary complications, chylothorax, myocardial injury, and all-cause mortality. Main Results: Sixty-five patients were included in the analysis. The incidence of postoperative complications between groups was similar (GDT 36.4% vs. control 37.5%, P = 0.92). The total fluid volume was not significantly different between the two groups (2,192 ± 469 vs. 2,201 ± 337 ml, P = 0.92). Compared with those in the control group ( n = 32), patients in the GDT group ( n = 33) received more colloids intraoperatively (874 ± 369 vs. 270 ± 67 ml, P & lt;0.05) and less crystalloid fluid (1,318 ± 386 vs. 1,937 ± 334 ml, P & lt;0.05). Conclusion: The colloid-based SVV optimization during GDT did not significantly reduce the incidence of early postoperative complications after minimally invasive esophagectomy in elderly patients. Clinical Trial Number and Registry URL: ChiCTR-INR-17013352; http://www.chictr.org.cn/showproj.aspx?proj=22883
Type of Medium:
Online Resource
ISSN:
2296-875X
DOI:
10.3389/fsurg.2021.794272
DOI:
10.3389/fsurg.2021.794272.s001
DOI:
10.3389/fsurg.2021.794272.s002
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2021
detail.hit.zdb_id:
2773823-1
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