Retrospective Analysis Of Correlation Between Fluid Volume Administration During Anesthesia And Postoperative Complications Of Gastrointestinal Malignant Tumors

Objietives: To analyze the effect of fluid volume administration during anesthesia on inflammatory response,complications and gastrointestinal function after laparoscopic gastrointestinal malignant tumor surgery,so as to explore the best range of fluid therapy amount during anesthesia.To analyze the risk factors of postoperative complications of gastrointestinal malignant tumor under laparoscope.Methods: Patients undergoing elective laparoscopic surgery for gastrointestinal malignant tumors from June 1st,2017 to May 31 st,2018 were collected from the Union Hospital Affiliated to Fujian Medical University.According to the inclusion criteria and exclusion criteria to select research objects.Part ?: The fluid volume administration(unit: ml/(kg·h))during anesthesia for laparoscopic gastric malignant tumor surgery is divided into three groups according to clinical work practice and statistical methods.group 1(8 ml/(kg·h))? fluid volume > 5 ml/(kg·h)): 352 cases,group 2(fluid volume ? 5 ml/(kg·h)): 101 cases,and group 3(fluid volume > 8 ml/(kg·h)): 194 cases.Part ?: The fluid volume administration(unit: ml/(kg·h))during anesthesia for laparoscopic colorectal cancer surgery is divided into two groups according to clinical practice and statistical methods: group 1(fluid volume ? 7 ml/(kg·h)): 307 cases,group 2(fluid volume > 7 ml/(kg·h)): 252 cases.Statistical methods were used to analyze the risk factors of postoperative complications of laparoscopic gastrointestinal malignant tumors,and then compare the postoperative complication rate,gastrointestinal function recovery time and postoperative hospital stay in patients with different fluid volume during anesthesia.The difference in determining the amount of fluid during anesthesia during laparoscopic gastrointestinal malignancy surgery;Univariate analysis and logistic binary regression were used to analyze the risk factors for postoperative complications of laparoscopic gastrointestinal malignancies.Laparoscopic surgery for gastric malignancies was performed by statistical analysis of differences in postoperative white blood cell counts and elevated serum C-reactive protein concentrations in different fluid volume groups and with or without complications during anesthesia.Result: A total of 1206 patients were included in this study.Logostic binary regression analysis showed that: age increase,diabetes,increased surgical duration,surgical site(stomach)is an independent risk factor for complications after laparoscopic gastrointestinal resection.Part I includes patients: 647 cases.1.1 The incidence of total complications and postoperative acute kidney injury in group 1 were significantly lower than those in group 2(P<0.05),while the incidence of postoperative acute kidney injury and gastrointestinal symptoms were significantly lower than those in group 3(P<0.05).The change range of leukocyte count in group 1 and group 3 was significantly smaller than that in group 2(P<0.05),and the C-reactive protein concentration in group 1 and group 3 was significantly lower than that in group 2(P<0.05).The postoperative exhaust in group 1 recovered faster than that in groups 2 and 3(P<0.05).There was no statistical significance in the difference of eating time,defecation time and hospitalization time among the three groups.1.2 Logostic binary regression analysis showed that fluid volume administration during anesthesia ? 5 ml/(kg·h)and > 8 ml/(kg·h),age increase,preoperative white blood cell count increase and operation time extension were independent risk factors for total complications after laparoscopic gastric malignant tumor surgery(P<0.05).Part ? includes patients: 559 cases.2.1 The incidence of postoperative complications and gastrointestinal obstruction in group 1 was significantly lower than those in group 2(P<0.05).The postoperative eating time of group 1 was significantly earlier than that of group 2(P<0.05).There was no significant difference in the incidence of other complications,postoperative exhaust time,defecation time and hospitalization time between the two groups.2.2 Logostic binary regression analysis showed that fluid volume administration during anesthesia > 7 ml/(kg·h),gender(male),prolonged operation time and operation mode(common laparoscope)were independent risk factors for total postoperative complications of laparoscopic colorectal malignant tumors(P<0.05).Conclusion: Fluid volume administration during anesthesia affects the postoperative inflammatory response and the incidence of complications.5-8 ml/(kg·h)is the appropriate fluid volume administration during anesthesia for elective laparoscopic gastric malignant tumor surgery.? 7 ml/(kg·h)is the appropriate fluid volume administration during anesthesia for elective laparoscopic colorectal cancer surgery.