Peroperative Fluid Management in Major Gynecological Cancer Surgeries

NCT ID: NCT06101498

Last Updated: 2023-11-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

180 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2023-09-01

Brief Summary

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The aim of this study is to evaluate the effect of perioperative fluid management on postoperative kidney damage in gynecological cancer surgeries.

The main question\[s\] it aims to answer are:

Does fluid management applied with different hemodynamic monitoring methods affect the risk of postoperative AKI? In our clinic, three different fluid management strategies are applied depending on the anesthetist experience. Acute kidney injury will be evaluated according to the postoperative AKIN classification of conventional fluid therapy and targeted fluid therapy with noninvasive or minimally invasive monitoring.

Detailed Description

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Our study was designed as a retrospective study. The files of patients over the age of 18 who underwent open abdominal surgery due to ASAII and III gynecological malignancy will be examined retrospectively. Patients who cannot be monitored peroperatively and who undergo HIPEC will be excluded from the study. Patients will be divided into 3 groups according to the fluid management strategy and the hemodynamic monitoring used: Group 1: patients receiving conventional fluid therapy; Group 2: patients receiving targeted fluid therapy with noninvasive monitoring; Group 3: patients receiving targeted fluid therapy with minimally invasive monitoring.

Conditions

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Fluid Overload Fluid Loss Perioperative/Postoperative Complications Acute Kidney Injury

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants

Study Groups

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Conventional fluid therapy

Patients who received conventional fluid therapy

Group Type EXPERIMENTAL

Akut kidnet injury(AKI)

Intervention Type DIAGNOSTIC_TEST

postoperative 24 hours

Non invaziv goal directed therapy

Patients who received non invaziv goal directed therapy

Group Type EXPERIMENTAL

Akut kidnet injury(AKI)

Intervention Type DIAGNOSTIC_TEST

postoperative 24 hours

Minimal invaziv goal directed therapy

Patients who received minimal invaziv goal directed therapy

Group Type EXPERIMENTAL

Akut kidnet injury(AKI)

Intervention Type DIAGNOSTIC_TEST

postoperative 24 hours

Interventions

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Akut kidnet injury(AKI)

postoperative 24 hours

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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AKI developing in the patient group receiving conventional treatment AKI developing in the patient group receiving non invaziv goal directed therapy AKI developing in the patient group receiving minimal invaziv goal directed therapy

Eligibility Criteria

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Inclusion Criteria

* \>18 years
* ASA II-III
* Those with normal renal function

Exclusion Criteria

* Patients in renal insufficiency
* Patients with perioperative renal, ureter \& bladder invasion
* Patients in whom perioperative urine monitoring cannot be performed
* Patients undergoing HIPEC
* Patients with missing data
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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Bakirkoy Dr. Sadi Konuk Research and Training Hospital

OTHER_GOV

Sponsor Role lead

Responsible Party

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Duygu Akyol

Principal investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Duygu Akyol

Role: PRINCIPAL_INVESTIGATOR

Başakşehir Çam & Sakura City Hospital

Locations

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Başakşehir Çam and Sakura City Hospital

Istanbul, Basaksehir, Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Yildiz GO, Hergunsel GO, Sertcakacilar G, Akyol D, Karakas S, Cukurova Z. Perioperative goal-directed fluid management using noninvasive hemodynamic monitoring in gynecologic oncology. Braz J Anesthesiol. 2022 May-Jun;72(3):322-330. doi: 10.1016/j.bjane.2021.12.012. Epub 2022 Feb 1.

Reference Type RESULT
PMID: 35121063 (View on PubMed)

Yu J, Che L, Zhu A, Xu L, Huang Y. Goal-Directed Intraoperative Fluid Therapy Benefits Patients Undergoing Major Gynecologic Oncology Surgery: A Controlled Before-and-After Study. Front Oncol. 2022 Apr 6;12:833273. doi: 10.3389/fonc.2022.833273. eCollection 2022.

Reference Type RESULT
PMID: 35463383 (View on PubMed)

Russo A, Aceto P, Grieco DL, Anzellotti GM, Perilli V, Costantini B, Romano B, Scambia G, Sollazzi L, Antonelli M. Goal-directed hemodynamic management in patients undergoing primary debulking gynaecological surgery: A matched-controlled precision medicine study. Gynecol Oncol. 2018 Nov;151(2):299-305. doi: 10.1016/j.ygyno.2018.08.034. Epub 2018 Sep 7.

Reference Type RESULT
PMID: 30201234 (View on PubMed)

Hasselgren E, Hertzberg D, Camderman T, Bjorne H, Salehi S. Perioperative fluid balance and major postoperative complications in surgery for advanced epithelial ovarian cancer. Gynecol Oncol. 2021 May;161(2):402-407. doi: 10.1016/j.ygyno.2021.02.034. Epub 2021 Mar 12.

Reference Type RESULT
PMID: 33715894 (View on PubMed)

McKenny M, Conroy P, Wong A, Farren M, Gleeson N, Walsh C, O'Malley C, Dowd N. A randomised prospective trial of intra-operative oesophageal Doppler-guided fluid administration in major gynaecological surgery. Anaesthesia. 2013 Dec;68(12):1224-31. doi: 10.1111/anae.12355. Epub 2013 Sep 30.

Reference Type RESULT
PMID: 24116747 (View on PubMed)

Other Identifiers

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2023.478

Identifier Type: -

Identifier Source: org_study_id