Surgery Today

, Volume 49, Issue 5, pp 427–434 | Cite as

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

  • Takeo FujitaEmail author
  • Naoya Okada
  • Yasumasa Horikiri
  • Takuji Sato
  • Hisashi Fujiwara
  • Shuhei Mayanagi
  • Jun Kanamori
  • Hiroyuki Yamamoto
  • Hiroyuki Daiko
Original Article



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.


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.


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.


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.


Esophageal cancers Esophagectomy Hydroxyethyl starch 6% 130/0.4/9 



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.

Author contributions

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.

Compliance with ethical standards

Conflict of interest

There are no financial relationships or support that may pose a conflict of interest.


The content has not been published or submitted for publication elsewhere.

Supplementary material

595_2018_1752_MOESM1_ESM.tif (105 kb)
Supplementary material 1 (TIF 105 KB)


  1. 1.
    Nishi M, Hiramatsu Y, Hioki K, Kojima Y, Sanada T, Yamanaka H, et al. Risk factors in relation to postoperative complications in patients undergoing esophagectomy or gastrectomy for cancer. Ann Surg. 1988;207:148–54.CrossRefGoogle Scholar
  2. 2.
    Böck JC, Barker BC, Clinton AG, Wilson MB, Lewis FR. Post-traumatic changes in, and effect of colloid osmotic pressure on the distribution of body water. Ann Surg. 1989;210:395–403.CrossRefGoogle Scholar
  3. 3.
    Kozek-Langenecker SA, Afshari A, Albaladejo P, Santullano CA, De Robertis E, Filipescu DC, et al. Management of severe perioperative bleeding: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol. 2013;30:270–382.CrossRefGoogle Scholar
  4. 4.
    Raue W, Haase O, Langelotz C, Neuss H, Müller JM, Schwenk W. Influence of pre-operative fluid infusion on volume status during oesophageal resection—a prospective trial. Acta Anaesthesiol Scand. 2008;52:1218–25.CrossRefGoogle Scholar
  5. 5.
    Ishikawa S, Nakazawa K, Makita K. Progressive changes in arterial oxygenation during one-lung anaesthesia are related to the response to compression of the non-dependent lung. Br J Anaesth. 2003;90:21–6.CrossRefGoogle Scholar
  6. 6.
    Müller JM, Erasmi H, Stelzner M, Zieren U, Pichlmaier H. Surgical therapy of oesophageal carcinoma. Br J Surg. 1990;77:845–57.CrossRefGoogle Scholar
  7. 7.
    Fujita T, Daiko H. Early enteral nutrition reduces the rate of life-threatening complications after thoracic esophagectomy in patients with esophageal cancer. Eur Surg Res. 2012;48:79–84.CrossRefGoogle Scholar
  8. 8.
    Boyle NH, Pearce A, Hunter D, Owen WJ, Mason RC. Intraoperative scanning laser Doppler flowmetry in the assessment of gastric tube perfusion during esophageal resection. J Am Coll Surg. 1999;188:498–502.CrossRefGoogle Scholar
  9. 9.
    Bludau M, Hölscher AH, Vallböhmer D, Gutschow C, Schröder W. Ischemic conditioning of the gastric conduit prior to esophagectomy improves mucosal oxygen saturation. Ann Thorac Surg. 2010;90:1121–6.CrossRefGoogle Scholar
  10. 10.
    Feldheiser A, Pavlova V, Bonomo T, Jones A, Fotopoulou C, Sehouli J, et al. Balanced crystalloid compared with balanced colloid solution using a goal-directed haemodynamic algorithm. Br J Anaesth. 2013;110:231–40.CrossRefGoogle Scholar
  11. 11.
    Rasmussen KC, Johansson PI, Højskov M, Kridina I, Kistorp T, Thind P, et al. Hydroxyethyl starch reduces coagulation competence and increase blood loss during major surgery. Results from a randomized controlled trial. Ann Surg. 2014;2:249–54.CrossRefGoogle Scholar
  12. 12.
    Skhirtladze K, Base EM, Lassnigg A, Kaider A, Linke S, Dworschak M, et al. Comparison of the effects of albumin 5%, hydroxyethyl starch 130/0.4 6%, and Ringer’s lactate on blood loss and coagulation after cardiac surgery. Br J Anaesth. 2013;112:281–9.Google Scholar
  13. 13.
    Standl T, Lochbuehler H, Galli C, Reich A, Dietrich G, Hagemann H. HES 130/0.4 (Voluven) or human albumin in children younger than 2 year undergoing non-cardiac surgery. A prospective, randomized, open label, multicenter trial. Eur J Aesthesiol. 2008;25:437–45.CrossRefGoogle Scholar
  14. 14.
    Hosseinzadeh Maleki M, Derakhshan P, Rahmanian Sharifabad A, Amouzeshi A. Comparing the effects of 5% albumin and 6% hydroxyethyl starch 130/0.4 (Voluven) on renal function as priming solutions for cardiopulmonary bypass: A randomized double blind clinical trial. Anesth Pain Med. 2016;18:Epub.Google Scholar
  15. 15.
    Van der Linden P, De Villé A, Hofer A, Heschl M, Gombotz H. Six percent hydroxyethyl starch 130/0.4 (Voluven®) versus 5% human serum albumin for volume replacement therapy during elective open-heart surgery in pediatric patients. Anesthesiology. 2013;119:1296–309.CrossRefGoogle Scholar
  16. 16.
    Hung MH, Zou C, Lin FS, Lin CJ, Chan KC, Chen Y. New 6% hydroxyethyl starch 130/0.4 dose not increase blood loss during major abdominal surgery- a randomized control trial. J Formos Med Assoc. 2014;113:429–35.CrossRefGoogle Scholar
  17. 17.
    Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, et al. Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012;367:1901–11.CrossRefGoogle Scholar
  18. 18.
    Guo JR, Yu J, Jin XJ, Du JM, Guo W, Yuan XH. Effects of acute normovolemic hemodilution on perioperative coagulation and fibrinolysis in elderly patients undergoing hepatic carcnectomy. Chin Med Sci J. 2010;25:146–50.CrossRefGoogle Scholar
  19. 19.
    Li Y, He R, Ying X, Hahn RG. Ringer’s lactate, but not hydroxyethyl starch,prolongs the food intolerance time after major abdominal surgery; an open-labelled clinical trial. BMC Anesthesiol 2015;72.Google Scholar
  20. 20.
    Liang H, Yang C, Zhang B, Wang H, Liu H, Zhao Z, et al. Hydroxyethyl starch 200/0.5 decrease circulating tumor cells of colorectal cancer patients and reduces metastatic potential of colon cancer cell line through inhibiting platelets activation. Med Oncol J. 2015;32:151.CrossRefGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  • Takeo Fujita
    • 1
    Email author
  • Naoya Okada
    • 1
  • Yasumasa Horikiri
    • 1
  • Takuji Sato
    • 1
  • Hisashi Fujiwara
    • 1
  • Shuhei Mayanagi
    • 1
  • Jun Kanamori
    • 1
  • Hiroyuki Yamamoto
    • 2
  • Hiroyuki Daiko
    • 1
  1. 1.Division of Esophageal SurgeryNational Cancer Center Hospital EastKashiwaJapan
  2. 2.Division of AnesthesiologyNational Cancer Center Hospital EastKashiwaJapan

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