Perioperative management for thoracic esophageal cancer using intensive infusion of extracellular fluid solution

In order to clarify the usefullness of intensive infusion of extracellular fluid solution, we examined cardiopulmonary parameters, water and sodium metabolism and postoperative complications in 51 patients who underwent total thoracic esophagectomy. To maintain cardiac index significantly higher than the preoperative level, right ventricular end diastolic volume index were kept greater than 130 ml/ m². The intraoperative water intake was 15.3 ml/kg/h, and the water intake on the operation day was 5.2 ml/kg/h. Total water balance was the lowest on postoperative day 2 (POD2). The respiratory functions were improved from POD2. The oxygen delivery index were maintained over 650 ml/min/m², and the oxygen extraction rate were maintained under 25%. The incidence of postoperative complications were 13.7% for pulmonary complications, 13.7% for hyperbilirubinemia, 11.8% for arrhythmia, 3.9% for minor leakage and 2.0% for acute renal failure. We conclude that our postoperative management could ameliorate perioperative organ oxygen matabolism and achieve early recovery from surgical stress.