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The aim of this study is to evaluate the effect of perioperative fluid management on postoperative kidney damage in gynecological cancer surgeries.
The main question[s] it aims to answer are:
Does fluid management applied with different hemodynamic monitoring methods affect the risk of postoperative AKI? In our clinic, three different fluid management strategies are applied depending on the anesthetist experience. Acute kidney injury will be evaluated according to the postoperative AKIN classification of conventional fluid therapy and targeted fluid therapy with noninvasive or minimally invasive monitoring.
Our study was designed as a retrospective study. The files of patients over the age of 18 who underwent open abdominal surgery due to ASAII and III gynecological malignancy will be examined retrospectively. Patients who cannot be monitored peroperatively and who undergo HIPEC will be excluded from the study. Patients will be divided into 3 groups according to the fluid management strategy and the hemodynamic monitoring used: Group 1: patients receiving conventional fluid therapy; Group 2: patients receiving targeted fluid therapy with noninvasive monitoring; Group 3: patients receiving targeted fluid therapy with minimally invasive monitoring.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Conventional fluid therapy | Experimental | Patients who received conventional fluid therapy |
|
| Non invaziv goal directed therapy | Experimental | Patients who received non invaziv goal directed therapy |
|
| Minimal invaziv goal directed therapy | Experimental | Patients who received minimal invaziv goal directed therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Akut kidnet injury(AKI) | Diagnostic Test | postoperative 24 hours |
|
| Measure | Description | Time Frame |
|---|---|---|
| Evaluation of acute kidney injury | Our primary aim was to evaluate the postoperative day(POD1 ) creatinine values(mg/dl) | Change from preoperative to postoperative day 1(POD1)creatinine values(mg/dl) |
| Measure | Description | Time Frame |
|---|---|---|
| Peroperative fluid amounts | The seconder aim to investigate the amount of fluid used peroperatively | during the operation period |
| Measure | Description | Time Frame |
|---|---|---|
| The intensive care unit admission | The other aim to investigate the intensive care unit admission | posoperatively up to 1 months |
| Length of stay | The other aim to evaluate the duration of hospital stay. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Duygu Akyol | Başakşehir Çam & Sakura City Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Başakşehir Çam and Sakura City Hospital | Istanbul | Basaksehir | 3268 | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35121063 | Result | Yildiz GO, Hergunsel GO, Sertcakacilar G, Akyol D, Karakas S, Cukurova Z. Perioperative goal-directed fluid management using noninvasive hemodynamic monitoring in gynecologic oncology. Braz J Anesthesiol. 2022 May-Jun;72(3):322-330. doi: 10.1016/j.bjane.2021.12.012. Epub 2022 Feb 1. | |
| 35463383 | Result | Yu J, Che L, Zhu A, Xu L, Huang Y. Goal-Directed Intraoperative Fluid Therapy Benefits Patients Undergoing Major Gynecologic Oncology Surgery: A Controlled Before-and-After Study. Front Oncol. 2022 Apr 6;12:833273. doi: 10.3389/fonc.2022.833273. eCollection 2022. |
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| ID | Term |
|---|---|
| D004487 | Edema |
| D011183 | Postoperative Complications |
| D058186 | Acute Kidney Injury |
| ID | Term |
|---|---|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010335 | Pathologic Processes |
| D051437 | Renal Insufficiency |
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|
| postoperative 30 days |
| 30201234 | Result | Russo A, Aceto P, Grieco DL, Anzellotti GM, Perilli V, Costantini B, Romano B, Scambia G, Sollazzi L, Antonelli M. Goal-directed hemodynamic management in patients undergoing primary debulking gynaecological surgery: A matched-controlled precision medicine study. Gynecol Oncol. 2018 Nov;151(2):299-305. doi: 10.1016/j.ygyno.2018.08.034. Epub 2018 Sep 7. |
| 33715894 | Result | Hasselgren E, Hertzberg D, Camderman T, Bjorne H, Salehi S. Perioperative fluid balance and major postoperative complications in surgery for advanced epithelial ovarian cancer. Gynecol Oncol. 2021 May;161(2):402-407. doi: 10.1016/j.ygyno.2021.02.034. Epub 2021 Mar 12. |
| 24116747 | Result | McKenny M, Conroy P, Wong A, Farren M, Gleeson N, Walsh C, O'Malley C, Dowd N. A randomised prospective trial of intra-operative oesophageal Doppler-guided fluid administration in major gynaecological surgery. Anaesthesia. 2013 Dec;68(12):1224-31. doi: 10.1111/anae.12355. Epub 2013 Sep 30. |
| D007674 | Kidney Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |