Retrospective review of anesthesia techniques and postoperative complications in patients with uremia undergoing colorectal cancer surgery

Table 1 Baseline characteristics of the study population

Characteristic	Total (n = 120)	Stage 3 (n = 65)	Stage 4 (n = 40)	Stage 5 (n = 15)	P value
Age (years)	68.2 ± 9.1	67.8 ± 8.7	69.0 ± 9.3	69.5 ± 9.5	0.135
Men (%)	59.2	58.5	60.0	60.0	0.789
Primary malignancy (%)
Colorectal cancer	47.5	46.2	50.0	40.0	0.765
Gastric cancer	37.5	36.2	40.0	30.0	0.532
Other	15.0	17.5	12.5	20.0	0.204
Comorbidities (%)
Hypertension	73.3	74.0	72.5	80.0	0.612
Diabetes mellitus	35.8	34.2	37.5	33.3	0.842
Cardiovascular disease	29.2	28.5	32.5	30.0	0.523

Table 2 Anesthesia management patterns

Parameter	Total (n = 120)	Inhalational (n = 71)	TIVA (n = 49)	P value
Type of anesthesia (%)	Inhalational: 59.2%	TIVA: 40.8%	-	-
Duration of surgery (minutes)	190 ± 40	192 ± 38	187 ± 42	0.056
Intraoperative BIS	47.0 ± 4.0	47.2 ± 3.8	46.8 ± 4.2	0.321
Mean arterial pressure (%)	83.3	81.0	85.5	< 0.0011
Intraoperative fentanyl (μg/kg)	4.0 (3.0-4.5)	4.2 (3.1-4.8)	3.8 (2.8-4.4)	0.045

¹P < 0.05 comparison between inhalational and total intravenous anesthesia groups.

BIS: Bispectral index; TIVA: Total intravenous anesthesia.

Table 3 Fluid management and hemodynamic parameters

Parameter	Total (n = 120)	GDT (n = 62)	Standard (n = 58)	P value
Total intraoperative fluids (mL)	2750 (2200-3300)	2400 (2000-3000)	3100 (2700-4000)	< 0.0011
Crystalloid (%)	86.0	88.5	83.5	< 0.001
Blood loss > 500 mL (%)	25.0	23.5	26.3	0.321
Blood transfusion (%)	18.3	17.7	19.0	0.184
Cumulative fluid balance > 2000 mL (%)	31.7	20.3	42.0	< 0.0011

¹P < 0.05 comparison between goal-directed fluid therapy and standard fluid management groups.

GDT: Goal-directed fluid therapy.

Table 4 Incidence of postoperative complications by uremic stage

Uremic stage	Number of Patients	Complications (%)	P value
3	65	19.2	0.0241
4	40	25.0
5	15	33.3

¹P < 0.05 comparison across uremic stages.

Table 5 Postoperative outcomes based on complication status

Outcome	Complications (n = 28)	No complications (n = 92)	P value
Length of stay (days)	15 (13-20)	11 (8-14)	< 0.0011
Major complications, n (%)	21 (75.0)	0 (0)	0.003
30-day mortality (%)	3.6	2.2	0.310

¹P < 0.05 comparison between the complication and no complication groups.

Table 6 Subgroup analysis of postoperative complication incidence

Subgroup	Complications (%)	P value
Anesthetic technique
Inhalational vs TIVA	26.7 vs 20.0	0.0381
Fluid management
Standard vs GDT	28.2 vs 19.5	0.0301
Uremic stage 4-5: Standard vs GDT	33.3 vs 25.0	0.0151

¹P < 0.05 comparison within each subgroup.

TIVA: Total intravenous anesthesia; GDT: Goal-directed fluid therapy.