A comparative study of groups by age for the intra- and postoperative water and electrolyte management of oesophageal carcinoma.

The present study examined the effects of subtotal oesophagectomy through a right thoracal and abdominal approach, on the postoperative water-electrolyte metabolism and cardio-pulmonary function of patients with thoracic oesophageal carcinoma. The primary water balance, total sodium intake, urinary NAG index, free-water clearance (CH2O), oxygen diffusion function of the lungs to aerate blood (DLO2-Index), and alpha-human atrial natriuretic polypeptide (alpha-hANP) were measured perioperatively until the seventh day. Subjects were divided by age according to whether they were older or younger than 70 years into 2 groups. In both groups, no change was observed in the primary water balance, total sodium intake, urinary NAG index or CH2O. However, all of the patients in the older group exhibited significantly higher alpha-hANP values than those in the control group, and the DLO2-Index was also higher in the former subjects during the first 3 days following surgery. It may be concluded that alpha-hANP is a hormone of considerable importance as it is secreted in large amounts in response to increased stress on the cardio-pulmonary system and serves to normalize the water balance causing this extra load.