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- Title
Pelvic exenteration associated with future renal dysfunction.
- Authors
Sando, Masanori; Uehara, Kay; Li, Yuanying; Aiba, Toshisada; Ogura, Atsushi; Ebata, Tomoki; Kodera, Yasuhiro; Yatsuya, Hiroshi; Nagino, Masato
- Abstract
Purpose: This study aimed to clarify the long-term change in the renal function after pelvic exenteration (PE) and to evaluate the risk factors for any future dysfunction. Methods: This study comprised 40 patients. A greater than 25% decline in the estimated glomerular filtration rate (eGFR) at 3 years was defined as early renal function disorder (ERFD), possibly predicting future chronic kidney disease (CKD). Results: In the entire cohort, the median eGFR decreased by 23% at 3 years, and CKD developed in 50%. The patients were divided into the ERFD (n = 16) and non-ERFD (n = 24) groups. In the ERFD group, the eGFR significantly decreased by 28% during the first 1.5 years and continued to decline after that, resulting in 81.3% of patients reaching CKD, whereas it was 4% and 37.5%, respectively, in the non-ERFD group. In a growth model analysis, late urinary tract complications (UTC) and small bowel obstruction were shown to be risk factors for ERFD. Conclusion: Although PE was associated with a high incidence of future CKD, ERFD could predict it. Close observation of the eGFR decline over 1.5 years might be beneficial to identify ERFD patients. High-risk patients with late UTC and small bowel obstruction should, therefore, be observed carefully.
- Subjects
PELVIC exenteration; CHRONIC kidney failure; GLOMERULAR filtration rate; BOWEL obstructions; URINARY organs
- Publication
Surgery Today, 2020, Vol 50, Issue 12, p1601
- ISSN
0941-1291
- Publication type
Article
- DOI
10.1007/s00595-020-02036-0