Original CommunicationRestricted peri-operative fluid administration adjusted by serum lactate level improved outcome after major elective surgery for gastrointestinal malignancy
Section snippets
Patients
This study was approved by the Institutional Ethics Committee of Medical College, Nanjing University, and written informed consent was obtained from patients or the closest relative of each patient. This was a prospective, randomized study conducted from July 1, 2007 to July 31, 2008 in the Research Institute of General Surgery of Medical College, Nanjing University. Patients enrolled in the clinical trial were selected from 5 different units of our department. A minimum of 30 patients was
Results
During the period of study, 415 patients presented for operative resection of a gastrointestinal neoplasm. Of these, 103 were excluded (28 were unfit for operation or opted not to undergo the operation, 24 had metastatic disease, 4 had clinical depression, and 9 underwent operation with another surgical specialty; in addition, informed consent was not possible for 38 patients). Of the remaining 312 patients, 13 patients declined to take part in the study. Therefore, 299 patients were recruited
Discussion
We performed a study to compare a regimen of restricted intravenous fluid with supplemental intravenous fluids given according to the serum lactate concentration with a more standard restricted regimen with supplemental intravenous fluid administered according to the usual clinical parameters (blood pressure, pulse, urine output, etc.) on complications after major elective operation for gastrointestinal malignancies. We found that a fluid-restricted regimen after gastrointestinal operation may
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