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

• Published in: Surgery today (Tokyo, Japan) Vol. 49; no. 5; pp. 427 - 434
• Main Authors: Fujita, Takeo, Okada, Naoya, Horikiri, Yasumasa, Sato, Takuji, Fujiwara, Hisashi, Mayanagi, Shuhei, Kanamori, Jun, Yamamoto, Hiroyuki, Daiko, Hiroyuki
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.05.2019
• Subjects: Aged; Creatinine - blood; Esophageal Neoplasms - physiopathology; Esophageal Neoplasms - surgery; Esophagectomy - methods; Female; Fluid Therapy; Hemodynamics; Humans; Hydroxyethyl Starch Derivatives - administration & dosage; Incidence; Lymph Node Excision - methods; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Perioperative Care; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Safety; Serum Albumin, Human - administration & dosage; Solutions; Surgery; Surgical Oncology; Treatment Outcome; Esophagectomy; Esophageal cancers; Hydroxyethyl starch 6% 130/0.4/9
• ISSN: 0941-1291; 1436-2813; 1436-2813
• DOI: 10.1007/s00595-018-1752-6

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.