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Safety and efficacy of hydroxyethyl starch 6% 130/0.4/9 solution versus 5% human serum albumin in thoracic esophagectomy with 3-field lymph nodes dissection

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Abstract

Purpose

We investigated the safety and efficacy of administering hydroxyethyl starch 6% 130/0.4/9 (HES130/0.4/9) versus 5% human serum albumin (HSA), perioperatively, to patients undergoing thoracic esophagectomy with 3-field lymph-node dissection for esophageal cancer.

Methods

The subjects of this study were 262 patients, scheduled to undergo thoracic esophagectomy for esophageal cancer, who were assigned to one of two groups based on the fluid replacement therapy. We compared the intraoperative and immediate postoperative hemodynamics and incidence of complications in the two groups.

Results

Neither group suffered any adverse events. No significant differences were observed in systolic/diastolic blood pressure, heart rate, incidence of postoperative complications, postoperative urine output, or serum creatinine levels, between the groups. A mild postoperative increase (×1.5 increase) in serum creatinine levels was seen in 9.5% and 9.5% of patients in the HSA and HES130/0.4/9 groups, respectively (p = 0.99), and a moderate postoperative increase (×2.0 increase) was seen in 4.4% and 3.1%, respectively (p = 0.84). Univariate and multivariate analyses revealed that the administration of hydroxyethyl starch was not associated with a postoperative increase in serum creatinine levels.

Conclusion

Hydroxyethyl starch 6% 130/0.4/9 was well tolerated and comparable to albumin with respect to its effect on renal function during thoracic esophagectomy with 3-field lymph-node dissection.

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Acknowledgements

We thank the members of the Division of Esophageal Surgery for their critical discussion of our manuscript. We also thank the members of the Division of Gastrointestinal Oncology for reviewing and discussing the study.

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Authors and Affiliations

  1. Division of Esophageal Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan

    Takeo Fujita, Naoya Okada, Yasumasa Horikiri, Takuji Sato, Hisashi Fujiwara, Shuhei Mayanagi, Jun Kanamori & Hiroyuki Daiko

  2. Division of Anesthesiology, National Cancer Center Hospital East, Kashiwa, Japan

    Hiroyuki Yamamoto

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  1. Takeo Fujita
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  2. Naoya Okada
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  3. Yasumasa Horikiri
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  4. Takuji Sato
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  5. Hisashi Fujiwara
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  6. Shuhei Mayanagi
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  7. Jun Kanamori
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  8. Hiroyuki Yamamoto
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  9. Hiroyuki Daiko
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All persons who meet authorship criteria are listed as authors, and all authors certify that they have participated sufficiently in the work to take public responsibility for the content, including participation in the concept, design, analysis, writing, or revision of the manuscript.

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Correspondence to Takeo Fujita.

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Fujita, T., Okada, N., Horikiri, Y. et al. Safety and efficacy of hydroxyethyl starch 6% 130/0.4/9 solution versus 5% human serum albumin in thoracic esophagectomy with 3-field lymph nodes dissection. Surg Today 49, 427–434 (2019). https://doi.org/10.1007/s00595-018-1752-6

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