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  4. Vol 7, Issue 1, 2026

A Systematic Review and Meta-Analysis of the Impact of Intraoperative Goal-Directed Fluid Therapy on Postoperative Complications in High-Risk Abdominal Surgery Patients

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DOI: 10.23977/medsc.2026.070104 | Downloads: 0 | Views: 111

Author(s)

Yang Limei 1, He Jiansheng 2, Li Qiao 2, Yang Aijie 3

Affiliation(s)

1 Department of Anesthesiology and Surgical Anesthesia, Yanliang District People's Hospital, Xi'an, Shaanxi, 710089, China
2 Shaanxi University of Chinese Medicine, Xianyang, Shaanxi, 712046, China
3 Department of Anesthesiology and Surgical Anesthesia, Xi'an Hospital of Traditional Chinese Medicine, Xi'an, Shaanxi, 710021, China

Corresponding Author

Yang Aijie

ABSTRACT

In order to systematically evaluate the impact of goal-directed fluid therapy (GDFT) compared to conventional fluid management on postoperative complications in high-risk abdominal surgery patients. We searched for Randomized controlled trials (RCTs) on GDFT for high-risk abdominal surgery electronically in PubMed, EMBASE, the Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Data, and VIP databases from inception until December 31, 2023. Two researchers independently screened literature, extracted data, and assessed risk of bias. Meta-analysis was performed by using RevMan 5.4 software. Resultly, nineteen RCTs involving 2846 patients were included. Meta-analysis showed that compared to conventional fluid management, GDFT significantly reduced the overall incidence of major postoperative complications [RR=0.74, 95% CI (0.66, 0.83), P<0.001], shortened postoperative hospital length of stay [MD= -1.8 days, 95% CI (-2.6, -1.0), P<0.001], and decreased the risk of acute kidney injury [RR=0.60, 95% CI (0.49, 0.74)], anastomotic leak [RR=0.69, 95% CI (0.51, 0.94)], and pulmonary infection [RR=0.64, 95% CI (0.52, 0.79)]. Subgroup analysis indicated that the benefits of GDFT were more pronounced in patients undergoing hepatectomy, pancreaticoduodenectomy, and those monitored using stroke volume variation (SVV)/pulse pressure variation (PPV). In conclusion, current evidence suggests that intraoperative GDFT for high-risk abdominal surgery patients can effectively reduce the risk of postoperative complications and shorten hospital stay, holding significant clinical application value.

KEYWORDS

Goal-directed fluid therapy; High-risk surgery; Abdominal surgery; Postoperative complications; Systematic review; Meta-analysis

CITE THIS PAPER

Yang Limei, He Jiansheng, Li Qiao, Yang Aijie. A Systematic Review and Meta-Analysis of the Impact of Intraoperative Goal-Directed Fluid Therapy on Postoperative Complications in High-Risk Abdominal Surgery Patients. MEDS Clinical Medicine (2026) Vol. 7: 23-32. DOI: http://dx.doi.org/10.23977/medsc.2026.070104.

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