Objective

The use of goal-directed fluid therapy (GDFT) has been shown to reduce complications and improve prognosis in high-risk abdominal surgery patients. However, the utilization of pulse pressure variation (PPV) guided GDFT in laparoscopic surgery remains a subject of debate. We hypothesized that utilizing PPV guidance for GDFT would optimize short-term prognosis in elderly patients undergoing laparoscopic radical resection for colorectal cancer compared to conventional fluid therapy.

Methods

Elderly patients undergoing laparoscopic radical resection of colorectal cancer were randomized to receive either PPV guided GDFT or conventional fluid therapy and explore whether PPV guided GDFT can optimize the short-term prognosis of elderly patients undergoing laparoscopic radical resection of colorectal cancer compared with conventional fluid therapy.

Results

The incidence of complications was significantly lower in the PPV group compared to the control group (32.8% vs. 57.1%, P = .009). Additionally, the PPV group had a lower occurrence of gastrointestinal dysfunction (19.0% vs. 39.3%, P = .017) and postoperative pneumonia (8.6% vs. 23.2%, P = .033) than the control group.

Conclusion

Utilizing PPV as a monitoring index for GDFT can improve short-term prognosis in elderly patients undergoing laparoscopic radical resection of colorectal cancer.

Registration number

ChiCTR2300067361; date of registration: January 5, 2023.

中文翻译：

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脉压变化引导目标直接液体治疗可减少接受腹腔镜结直肠癌根治术的老年患者的术后并发症：一项随机对照试验

客观的

目标导向液体治疗 (GDFT) 的使用已被证明可以减少高危腹部手术患者的并发症并改善预后。然而，脉压变化（PPV）引导的 GDFT 在腹腔镜手术中的应用仍然是一个争论的话题。我们假设，与传统液体疗法相比，利用 PPV 指导 GDFT 将优化接受腹腔镜结直肠癌根治术的老年患者的短期预后。

方法

将接受腹腔镜结直肠癌根治术的老年患者随机接受PPV引导的GDFT或常规液体治疗，探讨PPV引导的GDFT与常规液体治疗相比是否可以优化老年腹腔镜结直肠癌根治术患者的短期预后。

结果

与对照组相比，PPV 组的并发症发生率显着降低（32.8% vs. 57.1%，P  = .009）。此外，PPV 组胃肠道功能障碍（19.0% vs. 39.3%，P  = .017）和术后肺炎（8.6% vs. 23.2%，P  = .033）的发生率低于对照组。

结论

利用PPV作为GDFT的监测指标可以改善老年腹腔镜结直肠癌根治术患者的短期预后。

注册号码

奇CTR2300067361；注册日期：2023年1月5日。