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. 2023 Oct 26;13(11):1540.
doi: 10.3390/jpm13111540.

Analysis of Intraoperative Variables Responsible for the Increase in Lactic Acid in Patients Undergoing Debulking Surgery

Marta Soriano Hervás  1   2 , Daniel Robles-Hernández  3 , Anna Serra  2   4 , Rosa Játiva-Porcar  1   2 , Luis Gómez Quiles  2   5 , Karina Maiocchi  2   5 , Sara Llorca  2   5 , María Teresa Climent  2   4 , Antoni Llueca  2   4
Affiliations

Analysis of Intraoperative Variables Responsible for the Increase in Lactic Acid in Patients Undergoing Debulking Surgery

Marta Soriano Hervás et al. J Pers Med. .

Abstract

Background: Cytoreductive surgery (CRS) is a complex procedure with a high incidence of perioperative complications. Elevated lactacidaemia levels have been associated with complications and perioperative morbidity and mortality. This study aims to analyse the intraoperative variables of patients undergoing CRS and their relationship with lactacidaemia levels. Methods: This retrospective, observational study included 51 patients with peritoneal carcinomatosis who underwent CRS between 2014 and 2016 at the Abdomino-Pelvic Oncological Surgery Reference Unit (URCOAP) of the General University Hospital of Castellón (HGUCS). The main variable of interest was the level of lactic acid at the end of surgery. Intraoperative variables, including preoperative haemoglobin, duration of surgery, intraoperative bleeding, fluid therapy administered, administration of blood products, and intraoperative peritoneal cancer index (PCI), were analysed. Results: Positive correlations were found between lactic acid levels and PCI, duration of intervention, fluid therapy, intraoperative bleeding, and transfusion of blood products. Additionally, a negative correlation was observed between haemoglobin levels and lactic acid levels. Notably, the strongest correlations were found with operative PCI (ρ = 0.532; p-value < 0.001) and duration of surgery (ρ = 0.518; p-value < 0.001). Conclusions: PCI and duration of surgery are decisive variables in determining the prognosis of patients undergoing debulking surgery. This study suggests that, for each minute of surgery, lactic acid levels increase by 0.005 mmol/L, and for each unit increase in PCI, lactic acid levels increase by 0.060 mmol/L.

Keywords: administration of blood products; cytoreductive surgery; duration of surgery; fluid therapy administered; intraoperative bleeding; intraoperative peritoneal cancer index; lactic levels; preoperative haemoglobin.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Graphical representation of the Sugarbaker PC index.
Figure 2
Figure 2
Correlation matrix.
See this image and copyright information in PMC

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