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Pelvic exenteration associated with future renal dysfunction.

Masanori Sando1, Kay Uehara2, Yuanying Li3

  • 1Division of Surgical Oncology, Department of Surgery, Nagoya Graduate School of Medicine, Nagoya, Japan.

Surgery Today
|June 4, 2020
PubMed
Summary

Pelvic exenteration (PE) significantly impacts renal function, with 50% of patients developing chronic kidney disease (CKD). Early renal function disorder (ERFD) after PE predicts CKD, highlighting the need for careful monitoring.

Keywords:
Chronic kidney diseasePelvic exenterationRenal dysfunction

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Area of Science:

  • Urology
  • Nephrology
  • Oncology

Background:

  • Pelvic exenteration (PE) is a complex surgical procedure for advanced pelvic malignancies.
  • Long-term renal function changes and predictors of chronic kidney disease (CKD) after PE are not well-defined.

Purpose of the Study:

  • To investigate long-term renal function alterations following pelvic exenteration.
  • To identify risk factors associated with the development of renal dysfunction post-PE.

Main Methods:

  • A cohort of 40 patients undergoing PE was studied.
  • Early renal function disorder (ERFD) was defined as a >25% decline in estimated glomerular filtration rate (eGFR) at 3 years.
  • Growth model analysis was employed to identify risk factors for ERFD.

Main Results:

  • The median eGFR decreased by 23% at 3 years post-PE, with 50% of patients developing CKD.
  • Patients with ERFD (n=16) showed a significant eGFR decline within 1.5 years and an 81.3% incidence of CKD.
  • Late urinary tract complications (UTC) and small bowel obstruction were identified as risk factors for ERFD.

Conclusions:

  • Pelvic exenteration is associated with a high risk of developing CKD.
  • Early detection of renal function decline (ERFD) within 1.5 years can predict future CKD.
  • Patients with a history of late UTC or small bowel obstruction require close renal function monitoring after PE.