OBJECTIVE: To investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection. SUMMARY BACKGROUND DATA: Current fluid administration in major surgery causes a weight increase of 3-6 kg. Complications after colorectal surgery are reported in up to 68% of patients. Associations between postoperative weight gain and poor survival as well as fluid overload and complications have been shown. METHODS: We did a randomized observer-blinded multicenter trial. After informed consent was obtained, 172 patients were allocated to either a restricted or a standard intraoperative and postoperative intravenous fluid regimen. The restricted regimen aimed at maintaining preoperative body weight; the standard regimen resembled everyday practice. The primary outcome measures were complications; the secondary measures were death and adverse effects. RESULTS: The restricted intravenous fluid regimen significantly reduced postoperative complications both by intention-to-treat (33% versus 51%, P = 0.013) and per-protocol (30% versus 56%, P = 0.003) analyses. The numbers of both cardiopulmonary (7% versus 24%, P = 0.007) and tissue-healing complications (16% versus 31%, P = 0.04) were significantly reduced. No patients died in the restricted group compared with 4 deaths in the standard group (0% versus 4.7%, P = 0.12). No harmful adverse effects were observed. CONCLUSION: The restricted perioperative intravenous fluid regimen aiming at unchanged body weight reduces complications after elective colorectal resection.
RCT Entities:
OBJECTIVE: To investigate the effect of a restricted intravenous fluid regimen versus a standard regimen on complications after colorectal resection. SUMMARY BACKGROUND DATA: Current fluid administration in major surgery causes a weight increase of 3-6 kg. Complications after colorectal surgery are reported in up to 68% of patients. Associations between postoperative weight gain and poor survival as well as fluid overload and complications have been shown. METHODS: We did a randomized observer-blinded multicenter trial. After informed consent was obtained, 172 patients were allocated to either a restricted or a standard intraoperative and postoperative intravenous fluid regimen. The restricted regimen aimed at maintaining preoperative body weight; the standard regimen resembled everyday practice. The primary outcome measures were complications; the secondary measures were death and adverse effects. RESULTS: The restricted intravenous fluid regimen significantly reduced postoperative complications both by intention-to-treat (33% versus 51%, P = 0.013) and per-protocol (30% versus 56%, P = 0.003) analyses. The numbers of both cardiopulmonary (7% versus 24%, P = 0.007) and tissue-healing complications (16% versus 31%, P = 0.04) were significantly reduced. No patients died in the restricted group compared with 4 deaths in the standard group (0% versus 4.7%, P = 0.12). No harmful adverse effects were observed. CONCLUSION: The restricted perioperative intravenous fluid regimen aiming at unchanged body weight reduces complications after elective colorectal resection.
Authors: A Vignali; V W Fazio; I C Lavery; J W Milsom; J M Church; T L Hull; S A Strong; J R Oakley Journal: J Am Coll Surg Date: 1997-08 Impact factor: 6.113
Authors: Dong Hoon Jo; Oh Jeong; Jang Won Sun; Mi Ran Jeong; Seong Yeop Ryu; Young Kyu Park Journal: J Gastric Cancer Date: 2011-06-30 Impact factor: 3.720
Authors: Donald E Low; Sonia Kunz; Drew Schembre; Henry Otero; Tom Malpass; Alex Hsi; Guobin Song; Richard Hinke; Richard A Kozarek Journal: J Gastrointest Surg Date: 2007-08-31 Impact factor: 3.452
Authors: José E de Aguilar-Nascimento; Breno N Diniz; Aracelle V do Carmo; Eryka A O Silveira; Raquel M Silva Journal: World J Surg Date: 2009-02-21 Impact factor: 3.352
Authors: Andrew L Tambyraja; Fergus Sengupta; Alasdair B MacGregor; David C C Bartolo; Kenneth C H Fearon Journal: World J Surg Date: 2004-09-29 Impact factor: 3.352