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Abdominal surgery in patients undergoing long-term peritoneal dialysis
Surgery
|October 1, 1982
Summary
Patients on long-term peritoneal dialysis (LTPD) undergoing abdominal surgery face risks, including nutritional deficiencies and wound complications. Careful management, including timing of dialysis and surgical repair of hernias, is crucial for better outcomes.
Area of Science:
- Nephrology
- Surgical Gastroenterology
- Clinical Nutrition
Background:
- Long-term peritoneal dialysis (LTPD) patients undergoing abdominal surgery present unique challenges.
- Preoperative nutritional status and anemia are common concerns in this population.
- Wound integrity is critical to prevent dialysis fluid leakage.
Purpose of the Study:
- To evaluate outcomes of abdominal operations in patients on LTPD.
- To assess the nutritional status of LTPD patients.
- To provide recommendations for managing LTPD patients undergoing abdominal surgery.
Main Methods:
- Retrospective review of 19 patients undergoing abdominal operations (11 elective, 8 emergency) on LTPD.
- Nutritional assessment of 17 in-center LTPD patients, including skin testing and lymphocyte counts.
- Analysis of preoperative hemoglobin and serum albumin levels.
Main Results:
- Mortality was higher in the emergency group (4/8) compared to the elective group (1/11).
- Wound complications occurred in 5 patients.
- Prevalent nutritional deficiencies were noted, including impaired delayed hypersensitivity and low lymphocyte counts.
Conclusions:
- Elective abdominal surgery in LTPD patients should ideally be timed to delay dialysis postoperatively.
- Nutritional support and management of constipation are important.
- Transfer to hemodialysis may be indicated in some cases, especially with peritonitis.