Clinical Effect of Restrict Rehydration Strategy for Patients with Colorectal Cancer Combined Diabetes_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Wei ^1,2,3 , XIAO Ling ^1,2,3 , YU Xi ^1,2,4 , WANG Xiaodong ^1,2 , LI Li ^1,2

1.Center of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041;;
2.West China Hospital MCQ Team, Sichuan University, Chengdu 610041;;
3.West China College of Stomatology, Sichuan University, Chengdu 610041;;
4.West China Medical School, Sichuan University, Chengdu 610041Corresponding Author: LI Li, E-mail: drlili116@126.com;

Corresponding author：

Keywords：

Fluid administration; Diabetes; Colorectal cancer; Fast-track

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Objective 　To explore the impact of restrictive fluid administration for patients with colorectal cancer combined diabetes.
Methods 　The clinical data of patients diagnosed definitely as colorectal cancer with diabetes were analyzed retrospectively from January 2007 to October 2009 in this hospital, the clinical effects on postoperative early rehabilitation were studied and the differences between restrictive fluid regimen (fluid restriction group) and tradition fluid regimen (tradition therapy group) were compared.
Results 　The time of first aerofluxus and the first ambulation in fluid restriction group were shorter than those of tradition therapy group, the differences had statistical significances (P lt;0.05). The incidence of wound infection in fluid restriction group was lower than that in tradition therapy group (P lt;0.05). The differences of preoperative hemoglobin (Hb), white blood cell (WBC), glucose (GLU) and blood urea nitrogen (BUN) were not statistically significant between two groups, but the difference of postoperative GLU was statistically significant between two groups (P lt;0.05). Conclusion　 Restrictive fluid regimen can reduce the incidence of common complications after colorectal surgery for diabetic, and has a certain promoter action to the early rehabilitation after rectal surgery.

Citation： LI Wei ,XIAO Ling,YU Xi,WANG Xiaodong,LI Li. Clinical Effect of Restrict Rehydration Strategy for Patients with Colorectal Cancer Combined Diabetes. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(4): 399-403. doi: Copy

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2.	刘展, 汪晓东, 李立. 多学科协作诊治模式下的结直肠外科快速康复流程 [J]. 中国普外基础与临床杂志, 2007; 14(2): 239-242.
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4.	肖凌, 黄真真, 李蔚, 等. 快速流程模式中术后限制补液在老年结直肠癌患者中的应用价值 [J]. 中国普外基础与临床杂志, 2010; 17(1): 87-91.
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6.	吴在德, 吴肇汉. 外科学 [M]. 第7版. 北京: 人民卫生出版社, 2008: 66.
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9.	Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit [J]. Br J Surg, 1991; 78(3): 355-360.
10.	Dronge AS, Perkal MF, Kancir S, et al. Long-term glycemic control and postoperative infectious complications [J]. Arch Surg, 2006; 141(4): 375-380.
11.	Chung YW, Han DS, Park KH, et al. Insulin therapy and colorectal adenoma risk among patients with type 2 diabetes mellitus: a case-control study in Korea [J]. Dis Colon Rectum, 2008; 51(5): 593-597.
12.	Christopherson K. The impact of diabetes on wound healing: implications of microcirculatory changes [J]. Br J Community Nurs, 2003; 8(12): S6-S13.
13.	Mousley M. Diabetes and its effect on wound healing and patient care [J]. Nurs Times, 2003; 99(42): 70, 73-74.
14.	Lang K, Boldt J, Suttner S, et al. Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery [J]. Anesth Analg, 2001; 93(2): 405-409.
15.	von Heymann C, Grebe D, Schwenk W, et al. The influence of intraoperative fluid therapy on the postoperative outcome in “fast track” colon surgery [J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2006; 41(6): E1-E7.
16.	Lobo DN, Bjarnason K, Field J, et al. Changes in weight, fluid balance and serum albumin in patients referred for nutritional support [J]. Clin Nutr, 1999; 18: 197-201.
17.	Mller AM, Pedersen T, Svenden PE, et al. Perioperative risk factors in elective pneumonectomy: The impact of excess fluid balance [J]. Eur J Anaesthesiol, 2002; 19(1): 57-62.
18.	MacKay G, Fearon K, McConnachie A, et al. Randomized clinical trial of the effect of postoperative intravenous fluid restriction on recovery after elective colorectal surgery [J]. Br J Surg, 2006; 93(12): 1469-1474.
19.	Joshi GP. Intraoperative fluid restriction improves outcome after major elective gastrointestinal surgery [J]. Anesth Analg, 2005; 101(2): 601-605.
20.	Holte K, Jensen P, Kehlet H. Physiologic effects of intravenous fluid administration in healthy volunteers [J]. Anesth Analg, 2003; 96(5): 1504-1509.
21.	Wellby ML, Kennedy JA, Barreau PB, et al. Endocrine and cytokine changes during elective surgery [J]. J Clin Pathol,1994; 47(11): 1049-1051.
22.	Desborough JP. The stress response to surgery [J]. Br J Anaesth, 2000; 85(1): 109-117.
23.	Matthay MA, Fukuda N, Frank J, et al. Alveolar epithelial barrier. Role in lung fluid balance in clinical lung injury [J]. Clin Chest Med, 2000; 21(3): 477-490.
24.	Rahbari NN, Zimmermann JB, Schmidt T, et al. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery [J]. Br J Surg, 2009; 96(4): 331-341.
25.	Brandstrup B, Tnnesen H, Beier-Holgersen R, et al. Eff-ects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens. A randomized assessor blinded multi centre trial [J]. Ann Surg, 2003; 238(5): 641-648.

1. 　Schwenk W, Haase O, Raue W, et al. Establishing “fast track” colonic surgery in the clinical routine [J]. Zentralbl Chir, 2004; 129(6): 502-509.
2. 　刘展, 汪晓东, 李立. 多学科协作诊治模式下的结直肠外科快速康复流程 [J]. 中国普外基础与临床杂志, 2007; 14(2): 239-242.
3. 　Lobo DN, Bostock KA, Neal KR, et al. Effect of salt and water balance on recovery of gastrointestinal function after elective colonic resection: a randomised controlled trial [J]. Lancet, 2002; 359(9320): 1812-1818.
4. 　肖凌, 黄真真, 李蔚, 等. 快速流程模式中术后限制补液在老年结直肠癌患者中的应用价值 [J]. 中国普外基础与临床杂志, 2010; 17(1): 87-91.
5. 　Bower WF, Lee PY, Kong AP, et al. Peri-operative hyperglycemia: a consideration for general surgery? [J]. Am J Surg, 2010; 199(2): 240-248.
6. 　吴在德, 吴肇汉. 外科学 [M]. 第7版. 北京: 人民卫生出版社, 2008: 66.
7. 　Dukes C. The classification of cancer of the rectum [J]. J Pathol Bacteriol, 1932; 35(3): 323-332.
8. 　吕东昊, 汪晓东, 阳川华, 等. 结直肠肿瘤多学科协作诊治模式的数据库初期建设现状 [J]. 中国普外基础与临床杂志, 2007; 14(6): 713-716.
9. 　Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgical audit [J]. Br J Surg, 1991; 78(3): 355-360.
10. 　Dronge AS, Perkal MF, Kancir S, et al. Long-term glycemic control and postoperative infectious complications [J]. Arch Surg, 2006; 141(4): 375-380.
11. 　Chung YW, Han DS, Park KH, et al. Insulin therapy and colorectal adenoma risk among patients with type 2 diabetes mellitus: a case-control study in Korea [J]. Dis Colon Rectum, 2008; 51(5): 593-597.
12. 　Christopherson K. The impact of diabetes on wound healing: implications of microcirculatory changes [J]. Br J Community Nurs, 2003; 8(12): S6-S13.
13. 　Mousley M. Diabetes and its effect on wound healing and patient care [J]. Nurs Times, 2003; 99(42): 70, 73-74.
14. 　Lang K, Boldt J, Suttner S, et al. Colloids versus crystalloids and tissue oxygen tension in patients undergoing major abdominal surgery [J]. Anesth Analg, 2001; 93(2): 405-409.
15. 　von Heymann C, Grebe D, Schwenk W, et al. The influence of intraoperative fluid therapy on the postoperative outcome in “fast track” colon surgery [J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2006; 41(6): E1-E7.
16. 　Lobo DN, Bjarnason K, Field J, et al. Changes in weight, fluid balance and serum albumin in patients referred for nutritional support [J]. Clin Nutr, 1999; 18: 197-201.
17. 　Mller AM, Pedersen T, Svenden PE, et al. Perioperative risk factors in elective pneumonectomy: The impact of excess fluid balance [J]. Eur J Anaesthesiol, 2002; 19(1): 57-62.
18. 　MacKay G, Fearon K, McConnachie A, et al. Randomized clinical trial of the effect of postoperative intravenous fluid restriction on recovery after elective colorectal surgery [J]. Br J Surg, 2006; 93(12): 1469-1474.
19. 　Joshi GP. Intraoperative fluid restriction improves outcome after major elective gastrointestinal surgery [J]. Anesth Analg, 2005; 101(2): 601-605.
20. 　Holte K, Jensen P, Kehlet H. Physiologic effects of intravenous fluid administration in healthy volunteers [J]. Anesth Analg, 2003; 96(5): 1504-1509.
21. 　Wellby ML, Kennedy JA, Barreau PB, et al. Endocrine and cytokine changes during elective surgery [J]. J Clin Pathol,1994; 47(11): 1049-1051.
22. 　Desborough JP. The stress response to surgery [J]. Br J Anaesth, 2000; 85(1): 109-117.
23. 　Matthay MA, Fukuda N, Frank J, et al. Alveolar epithelial barrier. Role in lung fluid balance in clinical lung injury [J]. Clin Chest Med, 2000; 21(3): 477-490.
24. 　Rahbari NN, Zimmermann JB, Schmidt T, et al. Meta-analysis of standard, restrictive and supplemental fluid administration in colorectal surgery [J]. Br J Surg, 2009; 96(4): 331-341.
25. 　Brandstrup B, Tnnesen H, Beier-Holgersen R, et al. Eff-ects of intravenous fluid restriction on postoperative complications: comparison of two perioperative fluid regimens. A randomized assessor blinded multi centre trial [J]. Ann Surg, 2003; 238(5): 641-648.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Effect of Restrict Rehydration Strategy for Patients with Colorectal Cancer Combined Diabetes

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