Effect of intraoperative fluid volume on postoperative ileus after robot-assisted radical cystectomy
Authors
Ji Sung Shim ; Tae Il Noh ; Ja Hyeon Ku ; Sangchul Lee ; Tae Gyun Kwon ; Tae-Hwan Kim ; Seung Hyun Jeon ; Sang Hyup Lee ; Jong Kil Nam ; Wan Seok Kim ; Byong Chang Jeong ; Ji Youl Lee ; Sung Hoo Hong ; Koon Ho Rha ; Woong Kyu Han ; Won Sik Ham ; Young Goo Lee ; Yong Seong Lee ; Sung Yul Park ; Young Eun Yoon ; Sung Gu Kang ; Jong Jin Oh ; Seok Ho Kang
This study aimed to investigate the effect of intraoperative fluid volume on the postoperative ileus (POI) recovery period. A retrospective review of the Korean robot-assisted radical cystectomy database identified 718 patients who underwent robot-assisted radical cystectomy (RARC). Regression analyses were performed to identify the associations between the amount of intraoperative fluid administration (crystalloid/colloid/total), POI period (time to flatus/bowel movements), and length of hospital stay (LOS) after adjusting for covariates. In addition, we analyzed the risk factors for gastrointestinal complications and prolonged POI using a logistic regression model. An increasing volume of the administered crystalloid/total fluid was associated with prolonged POI (crystalloid R2 = 0.0725 and P < 0.0001; total amount R2 = 0.0812 and P < 0.0001), and the total fluid volume was positively associated with the LOS (R2 = 0.099 and P < 0.0001). The crystalloid amount was a risk factor for prolonged POI (P < 0.001; odds ratio, 1.361; 95% confidence interval, 1.133-1.641; P < 0.001). In the context of RARC, increased intravenous fluids are associated with prolonged POI and longer LOS.