title: Ratio of intra-operative fluid to anesthesia time and its impact on short term perioperative outcomes following gastrectomy for cancer: A retrospective cohort study.
abstract: BACKGROUND
  This study evaluates the short-term impact of fluid administration during gastrectomy for cancer.
  
  
  METHODS
  A multi-institutional database of patients undergoing gastrectomy for cancer from three tertiary centers was reviewed. Logistic and linear regression analyses were performed.
  
  
  RESULTS
  205 patients were included. The majority of patients (n = 116, 57%) underwent proximal or total gastrectomy. Median anesthesia time was 280 min (range 95-691 min). Median intraoperative crystalloid administration was 2901 ml (range 500-10,700 ml). Median colloid administration was 0 (range 0-3835 ml), although only 66 patients (32%) received colloid. On multivariate analysis, patients who received <10.0 ml total fluid per minute of anesthesia had a significantly higher risk of complications (OR 4.12, p = 0.010). Crystalloid and total fluid administration ratios did not significantly affect LOS or discharge disposition.
  
  
  CONCLUSIONS
  Restricting intra-operative fluid resuscitation to <10 ml total fluid per minute anesthesia is associated with an increased risk of complications in patients undergoing gastrectomy for cancer.
authors.affiliation: The Pennsylvania State University, College of Medicine, Department of Surgery, 500 University Drive, MC-H159, Hershey, PA 17033-0850, USA. Electronic address: lenomoto@hmc.psu.edu.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Enomoto
authors.affiliation: Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Electronic address: Aaron.Blackham@moffitt.org.
authors.forename: Aaron
authors.initials: A
authors.lastname: Blackham
authors.affiliation: Department of Surgery, Columbia University Medical Center, New York, NY 10032, USA. Electronic address: ywoo72@msn.com.
authors.forename: Yanghee
authors.initials: Y
authors.lastname: Woo
authors.affiliation: Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Electronic address: maki.yamamoto@uci.edu.
authors.forename: Maki
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL 33612, USA. Electronic address: Jose.Pimiento@moffitt.org.
authors.forename: Jose
authors.initials: J
authors.lastname: Pimiento
authors.affiliation: Program for Liver, Pancreas, & Foregut Tumors, Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, USA. Electronic address: ngusani@hmc.psu.edu.
authors.forename: Niraj J
authors.initials: NJ
authors.lastname: Gusani
authors.affiliation: Program for Liver, Pancreas, & Foregut Tumors, Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA 17033, USA. Electronic address: jwong1@hmc.psu.edu.
authors.forename: Joyce
authors.initials: J
authors.lastname: Wong
mesh_terms: D000368:Aged; D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects; D005743:Gastrectomy; D006801:Humans; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D013997:Time Factors
keywords: Gastric cancer; Intraoperative fluid; Perioperative outcomes