Objective  To examine the renoprotective benefits of stroke volume variation (SVV)-guided fluid therapy in older patients undergoing laparoscopic colorectal cancer resection with combined administration of epidural and general anesthesia.

  Methods  A total of 100 older patients underwent laparoscopic colorectal cancer resection with combined administration of epidural and general anesthesia at The Affiliated Hospital of Inner Mongolia Medical University. Participants were randomly allocated into the control (group C) and experimental groups (group S). Each group consisted of an equal distribution of 50 patients. Group C received routine rehydration, while group S underwent SVV-guided fluid rehydration. To compare the two groups, the levels of serum creatinine (Scr), blood urea nitrogen (BUN), neutrophil gelatinase-associated lipocalin protein (NGAL), and kidney injury molecule-1 (KIM-1) were analyzed before and after surgery.

  Results   NGAL concentrations were significantly reduced in group S compared with those in group C at 2 and 24h after surgery (P=0.033, P=0.014). KIM-1 levels were significantly lower in group S than in group C 24h after surgery (P=0.012). Furthermore, Scr levels were significantly lower in group S than in group C 1 day after surgery (P=0.049). The incidence of postoperative acute kidney injury (AKI) was significantly higher in group C than in group S (P=0.027).

  Conclusions  In older patients undergoing laparoscopic radical resection of colorectal cancer, the implementation of SVV-guided fluid therapy can improve postoperative plasma markers of renal injury and reduce the incidence of postoperative AKI, thereby protecting renal function.