PDF(Pubmed)
Abstract：
Background: The surgical treatment of advanced ovarian cancer is associated with extensive tissue trauma, prolonged operating times and a considerable volume shift. It, therefore, represents a challenge for anaesthesiological management. Aim: The aim of this single-centre, retrospective, observational study was to investigate whether intraoperative extensive volume supply influences postoperative outcomes and long-term survival. Methods: The study included 73 patients with a mean (SD) age of 63 (13) years who underwent extensive tumour-reducing surgery for ovarian cancer between 2012 and 2015. The effect of the intraoperative fluid balance on postoperative complications, such as anastomotic insufficiency or pleural effusions, was investigated using logistic regression. Further, the influence of fluid balance, lactate and creatinine levels on 5-year survival was analysed in a Cox regression model. Associations between anaesthesia time and the intraoperative fluid balance were examined using Spearman\'s rank correlation coefficients. Results: The mean (SD) postoperative fluid balance in the considered patient cohort was 9.1 (3.4) litres (l) at a mean (SD) anaesthesia time of 529 (106) minutes. Cox regression did not reveal a statistically significant effect of the fluid balance, but it did reveal a statistically significant association between the lactate level 24 h following surgery and the 5-year survival (HR [95%-CI] fluid balance: 0.97 [0.85, 1.11]; HR [95%-CI] lactate: 1.79 [1.24, 2.58]). According to logistic regression, the intraoperative fluid balance was associated with an increased chance of postoperative complications in the considered patient cohort (OR [95%-CI] 1.28 [1.1, 1.54]). Conclusions: We could not detect a negative impact of an increased fluid balance on 5-year survival, but a negative impact on postoperative complications was found in our patient cohort.
摘要：
背景：晚期卵巢癌的手术治疗与广泛的组织创伤有关。延长的操作时间和相当大的体积变化。It,因此,代表了麻醉管理的挑战。目标：这个单一中心的目标，回顾性,观察性研究旨在调查术中大量容量供应是否会影响术后结局和长期生存率.方法：该研究包括73例平均年龄（SD）为63（13）岁的患者，他们在2012年至2015年期间接受了广泛的卵巢癌减瘤手术。术中液体平衡对术后并发症的影响,如吻合口功能不全或胸腔积液，使用逻辑回归进行了调查。Further,流体平衡的影响，在Cox回归模型中分析了乳酸和肌酐水平对5年生存率的影响.使用Spearman等级相关系数检查麻醉时间与术中液体平衡之间的关联。结果：在平均（SD）麻醉时间为529（106）分钟时，所考虑的患者队列中的平均（SD）术后液体平衡为9.1（3.4）升（l）。Cox回归未显示液体平衡的统计学显着影响，但它确实揭示了术后24h乳酸水平与5年生存率之间的统计学显著关联(HR[95%-CI]液体平衡:0.97[0.85,1.11];HR[95%-CI]乳酸:1.79[1.24,2.58]).根据逻辑回归，在所考虑的患者队列中,术中液体平衡与术后并发症发生率增加相关(OR[95%-CI]1.28[1.1,1.54]).结论：我们没有发现液体平衡增加对5年生存率的负面影响，但在我们的患者队列中发现了对术后并发症的负面影响.
