[A Case of Ascending Colon Adenocarcinoma on Peritoneal Dialysis Who Underwent Surgery with Interdisciplinary...

A 60s-year-old male on continuous ambulatory peritoneal dialysis(CAPD)with a history of peritoneal infection and ischemic cardiac disease was referred to our hospital for the evaluation of a positive fecal occult blood test. Colonoscopic examination revealed a hemi-circumferential ulcerated tumor of ascending colon and the tumor was diagnosed as an adenocarcinoma. Plain CT revealed no enlarged lymph node or distant metastasis, and open ileocecal resection was planned. Consultation with the department of nephrology identified 2 concerns for the continuation of CAPD; postoperative bacterial infection and the emergence of sclerosing encapsulating peritonitis(SEP). After confirmation of proper cardiac function, the switch from CAPD to hemodialysis(HD)before surgery was proposed to the patient, and the consent was gained. Owing to the good cooperation, arteriovenous fistula creation and HD induction were followed by surgery on 37th day after the consent. The postoperative course was smooth and the patient was transferred to the department of nephrology on postoperative day 11. Although proceeding with CAPD after surgery is attractive, switch from CAPD to HD before surgery with cooperation with nephrologists was a reasonable option, considering high morbidity rate of patients with chronic kidney disease and the possibility of the emergence of SEP.