Abstract
Hemodialysis patients who undergo surgery have a high risk of postoperative complications. The aim of this study was to determine whether colon cancer surgery can be safely performed in hemodialysis patients. This multicenter retrospective study included 1372 patients who underwent elective curative resection surgery for colon cancer between April 2016 and March 2020. Of the total patients, 19 (1.4%) underwent hemodialysis, of whom 19 (100%) had poor performance status and 18 had comorbidities (94.7%). Minimally invasive surgery was performed in 78.9% of hemodialysis patients. The postoperative complication rate was significantly higher in hemodialysis than non-hemodialysis patients (36.8% vs. 15.5%, p = 0.009). All postoperative complications in the hemodialysis patients were infectious type. Multivariate analysis revealed a significant association of hemodialysis with complications (odds ratio, 2.9362; 95%CI, 1.1384-7.5730; p = 0.026). Despite recent advances in perioperative management and minimally invasive surgery, it is necessary to be aware that short-term complications can still occur, especially infectious complications in hemodialysis patients.
Highlights
Colorectal cancer is the third most commonly diagnosed cancer worldwide and the number of patients continues to increase; there were an estimated 1.8 million new cases in 2018 [1]
Invasive surgery was performed in 78.9% of hemodialysis patients
The postoperative complication rate was significantly higher in hemodialysis than non-hemodialysis patients (36.8% vs. 15.5%, p = 0.009)
Summary
Colorectal cancer is the third most commonly diagnosed cancer worldwide and the number of patients continues to increase; there were an estimated 1.8 million new cases in 2018 [1]. The increased use of minimally invasive surgery and advances in perioperative management have improved perioperative performance following surgery for colorectal cancer [2–5]. Long-term survival has improved following advances in oral medications and medical devices, including hemodialysis (HD), HD patients encounter additional obstacles because they often have numerous other systemic comorbidities and are more likely to suffer postoperative complications [7]. Few studies have reported surgery for colon cancer in HD patients [8–11] The aim of this multicenter retrospective study is to determine whether colon cancer surgery can be safely performed in HD patients. The aim of this study was to determine whether colon cancer surgery can be safely performed in hemodialysis patients
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