title: Liberal versus restrictive fluid management in abdominal surgery: a meta-analysis.
abstract: OBJECTIVE
  This study compared perioperative restrictive fluid therapy to liberal (conventional) fluid therapy in patients undergoing major abdominal surgery and investigated the rate of post-operative morbidity (complication rates), recovery (time to flatus), and the length of hospital stay.
  
  
  METHODS
  The Medline, PubMed, Cochrane, and EMBASE databases were searched until June 18, 2015. Randomized controlled trials, two-arm prospective studies, and retrospective studies were included in our analyses. A sensitivity analysis, publication bias assessment, and quality assessment were performed.
  
  
  RESULTS
  The effects of the two therapies were similar in the subgroup analysis of patients who underwent hepato-gastroenterological surgery (P = 0.287). However, in a subgroup of patients who underwent vascular abdominal surgery, the restricted fluid treatment regimen was associated with a lower risk of complications in comparison with the conventional regimen (pooled OR = 0.12, 95 % CI 0.03-0.47, P = 0.002). There was no difference between the two regimens with respect to the incidence of cardiopulmonary complications (P = 0.733). However, the patients who received the restricted fluid treatment regimen had a shorter time to flatus (P = 0.031) and a shorter hospital stay (P = 0.033) than the patients who received the conventional regimen.
  
  
  CONCLUSIONS
  Restrictive fluid therapy and liberal conventional therapy were associated with similar rates of overall and cardiopulmonary complications; however, restrictive fluid therapy was associated with a more rapid recovery and a shorter length of hospital stay.
authors.affiliation: Central Operation Theatre, 1st Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan South Rd, Urumqi, Xinjiang, 830054, China.
authors.forename: Feng-Ju
authors.initials: FJ
authors.lastname: Jia
authors.affiliation: Department of Nursery, The Union Hospital Affiliated Tongji Medical School, Huazhong University of Science and Technology, Wuhan, Hubei Province, 430022, China.
authors.forename: Qiao-Yuan
authors.initials: QY
authors.lastname: Yan
authors.affiliation: Center of Medical Research and Data Processing, Xinjiang Chinese Medicine Hospital, Urumqi, Xinjiang, 830054, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Liver and Laparoscopic Surgery, Center of Digestive and Vascular Surgery, 1st Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, 830054, China.
authors.forename: Tuerhongjiang
authors.initials: T
authors.lastname: Tuxun
authors.affiliation: Central Operation Theatre, 1st Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan South Rd, Urumqi, Xinjiang, 830054, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: Central Operation Theatre, 1st Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan South Rd, Urumqi, Xinjiang, 830054, China. shaoli9988@163.com.
authors.forename: Li
authors.initials: L
authors.lastname: Shao
mesh_terms: D000005:Abdomen / Q000601:surgery*; D016206:Databases, Bibliographic; D013505:Digestive System Surgical Procedures; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D009017:Morbidity; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D020127:Recovery of Function / Q000502:physiology*; D012306:Risk; D013997:Time Factors; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
keywords: Abdominal surgery; Fluid management; Liberal fluid; Meta-analysis; Restrictive fluid; Surgery