{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:56:20Z","timestamp":1784238980315,"version":"3.55.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2020,11,20]],"date-time":"2020-11-20T00:00:00Z","timestamp":1605830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>The optimal perioperative fluid management during esophagectomy is still not clear. Liberal regimens have been associated with higher morbidity and respiratory complications. Restrictive regimens might raise concerns for kidney function and increase the need to associate vasopressors. The aim of this study was to investigate retrospectively the perioperative fluid administration during esophagectomy and to correlate this with postoperative respiratory outcome. All patients who underwent esophagectomy between January and December 2016 were retrospectively analyzed. Patient characteristics, type of surgery and postoperative course were reviewed. Fluid administration and vasopressor use were calculated intraoperatively and during the postoperative stay at the recovery unit. Fluid overload was defined as a positive fluid balance of more than 125\u00a0mL\/m2\/h during the first 24\u00a0hours. Patients were divided in 3 groups: GRP0 (no fluid overload\/no vasopressors); GRP1 (no fluid overload\/need for vasopressors); GRP2 (fluid overload with\/without vasopressors). Postoperative complications were prospectively recorded according to Esophagectomy Complications Consensus Group criteria. A total of 103 patients were analyzed: 35 (34%) GRP0, 50 (49%) GRP1 and 18 (17%) GRP2. No significant differences were found for age, treatment (neoadjuvant vs. primary), type of surgery (open\/minimally invasive), histology nor comorbidities. There were significant (P\u2009\u2264\u20090.001) differences in fluid balance\/m2\/h (75\u2009\u00b1\u200921\u00a0mL; 86\u2009\u00b1\u200922\u00a0mL and 144\u2009\u00b1\u200920\u00a0mL) across GRP0, GRP1 and GRP2, respectively. We found differences in respiratory complications (GRP0 (20%) versus GRP1 (42%; P\u2009=\u20090.034) and GRP0 (20%) versus GRP2 (61%; P\u2009=\u20090.002)) and \u201cComprehensive Complications Index\u201d (GRP0 (20.5) versus GRP1 (34.6; P\u2009=\u20090.015) and GRP0 (20.5) versus GRP2 (35.1; P\u2009=\u20090.009)). Multivariable analysis (binary logistic regression) for \u201cany respiratory complication\u201d was performed. Patients who received fluid overload (GRP2) had a 10.24 times higher risk to develop postoperative respiratory complications. When patients received vasopressors alone (GRP1), the chances of developing these complications were 3.57 times higher compared to GRP0. Among patients undergoing esophagectomy, there is a wide variety in the administration of fluid during the first 24\u00a0hours. There was a higher incidence of respiratory complications when patients received higher amounts of fluid or when vasopressors were used. We believe that a personalized and protocolized fluid administration algorithm should be implemented and that individual risk factors should be identified.<\/jats:p>","DOI":"10.1093\/dote\/doaa111","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T03:05:34Z","timestamp":1605927934000},"source":"Crossref","is-referenced-by-count":23,"title":["Perioperative fluid management in esophagectomy for cancer and its relation to postoperative respiratory complications"],"prefix":"10.1093","volume":"34","author":[{"given":"Eleni","family":"Van Dessel","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johnny","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Nafteux","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Van Veer","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8230-5649","authenticated-orcid":false,"given":"Lieven","family":"Depypere","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willy","family":"Coosemans","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Lerut","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium"},{"name":"Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Coppens","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium"},{"name":"Anesthesia and Algology Unit, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arne","family":"Neyrinck","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium"},{"name":"Anesthesia and Algology Unit, Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,20]]},"reference":[{"key":"2021071306114584400_ref1","doi-asserted-by":"crossref","first-page":"1887","DOI":"10.1016\/S0140-6736(12)60516-9","article-title":"Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial","volume":"379","author":"Biere","year":"2012","journal-title":"Lancet"},{"issue":"2","key":"2021071306114584400_ref2","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/SLA.0000000000002611","article-title":"Benchmarking complications associated with esophagectomy","volume":"269","author":"Low","year":"2019","journal-title":"Ann Surg"},{"key":"2021071306114584400_ref3","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003210","article-title":"Dutch Upper GI Cancer Audit (DUCA) group. Reporting National Outcomes after Esophagectomy and gastrectomy according to the Esophageal complications consensus group (ECCG)","author":"Werf","year":"2019","journal-title":"Ann Surg"},{"key":"2021071306114584400_ref4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.athoracsur.2008.03.017","article-title":"Association of perioperative fluid balance and adverse surgical outcomes in esophageal cancer and esophagogastric junction cancer","volume":"86","author":"Wei","year":"2008","journal-title":"Ann Thorac Surg"},{"key":"2021071306114584400_ref5","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/j.1442-2050.2010.01057.x","article-title":"Perioperative fluid management and major respiratory complications in patients undergoing esophagectomy","volume":"23","author":"Casado","year":"2010","journal-title":"Dis Esophagus"},{"key":"2021071306114584400_ref6","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/EJA.0000000000000908","article-title":"Goal-directed therapy during transthoracic oesophageal resection does not improve outcome","volume":"36","author":"Bahlmann","year":"2019","journal-title":"Eur J Anaesthesiol"},{"key":"2021071306114584400_ref7","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1093\/bja\/ael290","article-title":"Wet, dry or something else?","volume":"97","author":"Bellamy","year":"2006","journal-title":"Br J Anaesth"},{"key":"2021071306114584400_ref8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13741-015-0014-z","article-title":"Perioperative fluid therapy: a statement from the international fluid optimization group","volume":"4","author":"Navarro","year":"2015","journal-title":"Perioper Med"},{"key":"2021071306114584400_ref9","first-page":"687018","article-title":"Goal-directed fluid therapy using stroke volume variation does not result in pulmonary fluid overload in thoracic surgery requiring one-lung ventilation","volume":"2012","author":"Haas","year":"2012","journal-title":"Crit Care Res Prac"},{"key":"2021071306114584400_ref10","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1053\/j.jvca.2009.10.008","article-title":"Arterial pressure variation and goal-directed fluid therapy","volume":"24","author":"Cannesson","year":"2010","journal-title":"J Cardiothorac Vasc Anesth"},{"issue":"suppl 5","key":"2021071306114584400_ref11","doi-asserted-by":"crossref","first-page":"S692","DOI":"10.21037\/jtd.2018.11.141","article-title":"Application of standardized hemodynamic protocols within enhanced recovery after surgery programs to improve outcomes associated with anastomotic leak and conduit necrosis in patients undergoing esophagectomy","volume":"11","author":"Klevebro","year":"2019","journal-title":"J Thorac Dis"},{"issue":"3","key":"2021071306114584400_ref12","doi-asserted-by":"publisher","first-page":"e0172806","DOI":"10.1371\/jurnal.pone.0172806","article-title":"Effect of goal-directed therapy on outcome after esophageal surgery: a quality improvement study","volume":"12","author":"Veelo","year":"2017","journal-title":"PLoS One"},{"key":"2021071306114584400_ref13","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1007\/s00268-018-4786-4","article-title":"Guidelines for perioperative care in esophagectomy: enhanced recovery after surgery (ERAS) society recommendations","volume":"43","author":"Low","year":"2019","journal-title":"World J Surg"},{"key":"2021071306114584400_ref14","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1056\/NEJMoa1805101","article-title":"Hybrid minimally invasive esophagectomy for esophageal cancer","volume":"380","author":"Mariette","year":"2019","journal-title":"N Engl J Med"},{"key":"2021071306114584400_ref15","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1097\/SLA.0000000000003252","article-title":"Long-term survival in esophageal cancer after minimally invasive compared to open esophagectomy. A systematic review and meta-analysis","volume":"270","author":"Gottlieb-Vedi","year":"2019","journal-title":"Ann Surg"},{"key":"2021071306114584400_ref16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SLA.0b013e318296c732","article-title":"The comprehensive complication index: a novel continuous scale to measure surgical morbidity","volume":"258","author":"Slankamenac","year":"2013","journal-title":"Ann Surg"},{"key":"2021071306114584400_ref17","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1097\/SLA.0000000000001098","article-title":"International consensus on standardization of data collection for complications associated with Esophagectomy. 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