Short-term Postoperative Outcomes of Colorectal Cancer Patients With Chronic Renal Failure on Dialysis

Abstract

Background/Aim: Surgery for dialysis patients requires special attention because of their physical characteristics. This study aimed to investigate the shortterm postoperative outcomes of colorectal cancer patients with chronic renal failure (CRF) on dialysis and aimed to investigate safer treatment options for these patients. Patients and Methods: A total of 1,504 colorectal cancer patients who underwent primary resection between January 2008 and December 2018 were included. A retrospective analysis of clinical data, preoperative tumor markers (carcinoembryonic antigen and carbohydrate antigen 19-9), and the Clavien-Dindo (CD) classification was performed. Patients were stratified into Groups A and B based on their need for dialysis or not, respectively. Results: There were 20 and 1,484 patients in Groups A and B, respectively. No differences were observed regarding age, body mass index, and preoperative tumor markers. The rate of laparoscopic surgery was significantly lower in Group A than in Group B. There was one mortality in Group A due to pulmonary disease. Group A had a significantly higher rate of complications. Conclusion: CRF patients on dialysis who underwent colorectal cancer surgery tended to be ruled out of laparoscopic surgery, and their rates of postoperative complications were higher.

Renal Failure Without Hemodialysis Is a Risk Factor for Postoperative Complications in Colorectal Cancer Surgery

“…In our study, patients with RF exhibited significant differences in postoperative complications compared to those without RF. Previous studies reported complication rates ranging from 36.8 to 50% in HD patients after CRC surgery (7,8). The postoperative complication rate (CD ≥2) was 44.4% in this study with a severe complication rate of 17.7%, and there were no patient deaths within 30 days after surgery.…”

“…Most RF patients, including those undergoing HD, tend to have comorbid diseases, such as cardiovascular disease, atherosclerotic disease, metabolic disease, and diabetes mellitus (7,10). Additionally, they face many disadvantages, such as organ vulnerability, delayed healing, increased susceptibility to bleeding, and a higher risk of infection, leading to elevated perioperative complications (8).…”

Advantages of the Laparoscopic Approach Versus Open Surgery for Colorectal Cancer Patients Undergoing Hemodialysis

“…[12] Not surprisingly, compared to nondialysis patients, these patients were less likely to undergo a laparoscopic approach. [11,13] Recently, Shiraishi et al published a retrospective study of the clinical data of 19 hemodialysis patients who underwent elective curative resection of colorectal cancer. [14] Although approximately 80% of these patients underwent minimally invasive surgery, short-term complications still occurred more frequently in these patients than in nonhemodialysis patients (36.8% vs. 15.5%, p = 0.009).…”