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Effect of preoperative asymptomatic renal dysfunction on the clinical course after colectomy for colon cancer

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Abstract

Purpose

To evaluate the effect of mild renal dysfunction on the clinical course after colectomy in patients with colon cancer.

Methods

The subjects of this retrospective study were 263 patients who underwent surgical resection for colon cancer at our hospital between 2011 and 2015. Renal function was assessed based on preoperative estimated glomerular filtration rate (eGFR) values. Patients were divided into groups based on their eGFR value of 55 ml/min/1.73 m2. The Mann–Whitney U test, chi-square or Fisher exact test, and log-rank test were used in the data analysis.

Results

There were 59 patients (22.4%) in the low eGFR group and 204 patients in the normal eGFR group. There were differences between the groups in age, comorbidities, and the levels of hemoglobin, albumin, and serum creatinine. The overall postoperative complication rate, frequency of severe complications, and length of stay were significantly higher in the low eGFR group than in the normal eGFR group. Multivariate analysis revealed that low eGFR was the only independent risk factor for severe complications (Clavien–Dindo classification III/IV). There were no differences in survival between the groups.

Conclusion

Preoperative asymptomatic renal dysfunction may be correlated with the development of postoperative complications and a possible significant risk factor for severe complications after colon cancer surgery.

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References

  1. Brody H. Colorectal cancer. Nature. 2015;521(7551):S1.

    Article  CAS  Google Scholar 

  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394–424.

    Article  Google Scholar 

  3. Sukumar S, Roghmann F, Trinh VQ, Sammon JD, Gervais MK, Tan HJ, et al. National trends in hospital-acquired preventable adverse events after major cancer surgery in the USA. BMJ Open. 2013;3(6):e002843.

    Article  Google Scholar 

  4. Richards SJG, Senadeera SC, Frizelle FA. Sarcopenia, as assessed by psoas cross-sectional area, is predictive of adverse postoperative outcomes in patients undergoing colorectal cancer surgery. Dis Colon Rectum. 2020;63(6):807–15.

    Article  Google Scholar 

  5. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.

    Article  Google Scholar 

  6. Yap R, Wilkins S, Staples M, Oliva K, McMurrick PJ. The effect of diabetes on the perioperative outcomes of colorectal cancer surgery patients. PLoS ONE. 2016;11(12):e0167271.

    Article  Google Scholar 

  7. Nishizawa Y, Akagi T, Inomata M, Katayama H, Mizusawa J, Yamamoto S, et al. Risk factors for early postoperative complications after D3 dissection for stage II or III colon cancer: supplementary analysis of a multicenter randomized controlled trial in Japan (JCOG0404). Ann Gastroenterol Surg. 2019;3(3):310–7.

    Article  Google Scholar 

  8. Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–9.

    Article  Google Scholar 

  9. Watanabe J, Tatsumi K, Ota M, Suwa Y, Suzuki S, Watanabe A, et al. The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer. Int J Colorectal Dis. 2014;29(3):343–51.

    Article  Google Scholar 

  10. Clinical Outcomes of Surgical Therapy Study Group, Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M, et al. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9.

    Article  Google Scholar 

  11. Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.

    Article  Google Scholar 

  12. Frasson M, Flor-Lorente B, Rodríguez JL, Granero-Castro P, Hervás D, Alvarez Rico MA, et al. Risk factors for anastomotic leak after colon resection for cancer: multivariate analysis and nomogram from a multicentric, prospective, national study with 3193 patients. Ann Surg. 2015;262(2):321–30.

    Article  Google Scholar 

  13. Abe H, Mafune K. Risk factors for maintenance hemodialysis patients undergoing elective and emergency abdominal surgery. Surg Today. 2014;44(10):1906–11.

    Article  CAS  Google Scholar 

  14. AbuRahma AF, Alhalbouni S, Abu-Halimah S, Dean LS, Stone PA. Impact of chronic renal insufficiency on the early and late clinical outcomes of carotid artery stenting using serum creatinine vs glomerular filtration rate. J Am Coll Surg. 2014;218(4):797–805.

    Article  Google Scholar 

  15. Nakazato T, Nakamura T, Sekiya N, Sawa Y. Preoperative estimated glomerular filtration rate is an independent predictor of late cardiovascular morbidity after mitral valve surgery. Ann Thorac Cardiovasc Surg. 2014;20(5):390–7.

    Article  Google Scholar 

  16. Wang F, Dupuis JY, Nathan H, Williams K. An analysis of the association between preoperative renal dysfunction and outcome in cardiac surgery: estimated creatinine clearance or plasma creatinine level as measures of renal function. Chest. 2003;124(5):1852–62.

    Article  Google Scholar 

  17. Sirany AM, Chow CJ, Kunitake H, Madoff RD, Rothenberger DA, Kwaan MR. Colorectal surgery outcomes in chronic dialysis patients: an American College of Surgeons National Surgical Quality Improvement Program study. Dis Colon Rectum. 2016;59(7):662–9.

    Article  Google Scholar 

  18. Drolet S, Maclean AR, Myers RP, Shaheen AA, Dixon E, Donald BW. Morbidity and mortality following colorectal surgery in patients with end-stage renal failure: a population-based study. Dis Colon Rectum. 2010;53(11):1508–16.

    Article  Google Scholar 

  19. Nagai M, Sho M, Akahori T, Tanaka T, Kinoshita S, Nishiofuku H, et al. Impact of preoperative asymptomatic renal dysfunction on clinical course after pancreatoduodenectomy. J Hepatobil Pancreat Sci. 2015;22(11):810–8.

    Article  Google Scholar 

  20. Kirihataya Y, Wakatsuki K, Matsumoto S, Nakade H, Kunishige T, Miyao S, et al. Impact of pretreatment asymptomatic renal dysfunction on clinical course after esophagectomy. Surg Today. 2021;51(1):165–71.

    Article  Google Scholar 

  21. Matsuo S, Imai E, Horio M, Yasuda Y, Tomita K, Nitta K, et al. Revised equations for estimated GFR from serum creatinine in Japan. Am J Kidney Dis. 2009;53(6):982–92.

    Article  CAS  Google Scholar 

  22. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  Google Scholar 

  23. Mathew A, Devereaux PJ, O’Hare A, Tonelli M, Thiessen-Philbrook H, Nevis IF, et al. Chronic kidney disease and postoperative mortality: a systematic review and meta-analysis. Kidney Int. 2008;73(9):1069–81.

    Article  CAS  Google Scholar 

  24. Miyake K, Iwagami M, Ohtake T, Moriya H, Kume N, Murata T, et al. Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study. World J Emerg Surg. 2020;15(1):22.

    Article  Google Scholar 

  25. Newman LA, Mittman N, Hunt Z, Alfonso AE. Survival among chronic renal failure patients requiring major abdominal surgery. J Am Coll Surg. 1999;188(3):310–4.

    Article  CAS  Google Scholar 

  26. Iannuzzi JC, Deeb AP, Rickles AS, Sharma A, Fleming FJ, Monson JR. Recognizing risk: bowel resection in the chronic renal failure population. J Gastrointest Surg. 2013;17(1):188–94.

    Article  Google Scholar 

  27. Cloyd JM, Ma Y, Morton JM, Kurella Tamura M, Poultsides GA, Visser BC. Does chronic kidney disease affect outcomes after major abdominal surgery? Results from the National Surgical Quality Improvement Program. J Gastrointest Surg. 2014;18(3):605–12.

    Article  Google Scholar 

  28. Hu WH, Cajas-Monson LC, Eisenstein S, Parry L, Ramamoorthy S. Association of dialysis with adverse postoperative outcomes in colorectal cancer-an analysis of ACS-NSQIP. Int J Colorectal Dis. 2015;30(11):1557–62.

    Article  Google Scholar 

  29. Prowle JR, Kam EP, Ahmad T, Smith NC, Protopapa K, Pearse RM. Preoperative renal dysfunction and mortality after non-cardiac surgery. Br J Surg. 2016;103(10):1316–25.

    Article  CAS  Google Scholar 

  30. Harrison TG, Ruzycki SM, James MT, Ronksley PE, Zarnke KB, Tonelli M, et al. Estimated GFR and incidence of major surgery: a population-based cohort study. Am J Kidney Dis. 2021;77(3):365–75.

    Article  CAS  Google Scholar 

  31. Ui T, Obi Y, Shimomura A, Lefor AK, Fazl Alizadeh R, Said H, et al. High and low estimated glomerular filtration rates are associated with adverse outcomes in patients undergoing surgery for gastrointestinal malignancies. Nephrol Dial Transplant. 2019;34(5):810–8.

    Article  Google Scholar 

  32. Raphael KL. Metabolic acidosis and subclinical metabolic acidosis in CKD. J Am Soc Nephrol. 2018;29(2):376–82.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan

    Shinsaku Obara, Fumikazu Koyama, Hiroyuki Kuge, Takayuki Nakamoto, Naoya Ikeda, Yosuke Iwasa, Takeshi Takei, Tomomi Sadamitsu, Kosuke Fujimoto, Suzuka Harada & Masayuki Sho

  2. Division of Endoscopy, Nara Medical University Hospital, Nara, Japan

    Fumikazu Koyama & Takayuki Nakamoto

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  1. Shinsaku Obara
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Correspondence to Masayuki Sho.

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Obara, S., Koyama, F., Kuge, H. et al. Effect of preoperative asymptomatic renal dysfunction on the clinical course after colectomy for colon cancer. Surg Today 52, 106–113 (2022). https://doi.org/10.1007/s00595-021-02363-w

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  • DOI: https://doi.org/10.1007/s00595-021-02363-w

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