Key result
Restrictive fluid therapy significantly reduced the length of hospital stay by 2.971 days and decreased the risk of major postoperative complications by 68% (OR 0.32) compared to liberal fluid therapy in patients undergoing advanced ovarian cancer surgery.
Why the study?
Postoperative fluid management is vital for preventing perioperative morbidity and mortality in high-complexity advanced ovarian cancer surgery, but the feasibility and benefits of restrictive fluid therapy needed investigation.
Does restrictive fluid therapy reduce length of hospital stay and postoperative complications in patients with advanced ovarian cancer undergoing open radical surgery?
Cohort (n=71)
No
Does restrictive fluid therapy reduce length of hospital stay and postoperative complications in patients with advanced ovarian cancer undergoing open radical surgery?
Mean Difference: -2.971 (95% CI -5.818–-0.124)
Absolute Event Rate: 16.5% vs 21%
p-value: p=0.04
Restrictive fluid management significantly decreases the risk of major postoperative complications and shortens hospital stay after high-complexity advanced ovarian cancer surgery.
Background: Postoperative fluid management is vital for preventing perioperative morbidity and mortality in high-complexity advanced ovarian cancer surgery. We investigated the feasibility and benefits of restrictive fluid therapy on postoperative recovery. Methods: Patients with advanced ovarian cancer who underwent open radical surgery were randomized into the restrictive or liberal fluid group. The endpoints were the length of hospital stay post-surgery and the incidence of complications within 30 days. Results: The restrictive and liberal fluid regimen groups included 30 and 41 patients, respectively. The length of hospital stay was 16.5-days and 21.0-days for the restrictive and liberal group, respectively (p = 0.035). Multiple linear regression analysis showed that length of hospital stay was 2.971-days shorter in the restrictive group than in the liberal group (95% confidence interval (CI): –5.818~–0.124, p = 0.04). The incidence of complications at the end of 30 days was significantly lower in the restrictive group than in the liberal intravenous group (26.7% versus 51.2%; p = 0.032). Adjusted logistic regression demonstrated that restrictive group could significantly reduce the risk of postoperative complications by 68% (Odds Ratio 0.32, 95% CI: 0.11–0.91, p = 0.033). Conclusions: Restrictive fluid management after high-complexity advanced ovarian cancer surgery can significantly decrease the risk of major postoperative complications and facilitate postoperative recovery.
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Zhang et al. (2023) conducted a cohort in High-complexity advanced ovarian cancer (n=71). Restrictive fluid therapy vs. Liberal fluid replacement was evaluated on Length of hospital stay (MD -2.971, 95% CI -5.818~-0.124, p=0.04). Restrictive fluid therapy significantly reduced the length of hospital stay by 2.971 days and decreased the risk of major postoperative complications by 68% (OR 0.32) compared to liberal fluid therapy in patients undergoing advanced ovarian cancer surgery.
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