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Pelvic exenteration associated with future renal dysfunction

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Abstract

Purpose

This study aimed to clarify the long-term change in the renal function after pelvic exenteration (PE) and to evaluate the risk factors for any future dysfunction.

Methods

This study comprised 40 patients. A greater than 25% decline in the estimated glomerular filtration rate (eGFR) at 3 years was defined as early renal function disorder (ERFD), possibly predicting future chronic kidney disease (CKD).

Results

In the entire cohort, the median eGFR decreased by 23% at 3 years, and CKD developed in 50%. The patients were divided into the ERFD (n = 16) and non-ERFD (n = 24) groups. In the ERFD group, the eGFR significantly decreased by 28% during the first 1.5 years and continued to decline after that, resulting in 81.3% of patients reaching CKD, whereas it was 4% and 37.5%, respectively, in the non-ERFD group. In a growth model analysis, late urinary tract complications (UTC) and small bowel obstruction were shown to be risk factors for ERFD.

Conclusion

Although PE was associated with a high incidence of future CKD, ERFD could predict it. Close observation of the eGFR decline over 1.5 years might be beneficial to identify ERFD patients. High-risk patients with late UTC and small bowel obstruction should, therefore, be observed carefully.

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Authors and Affiliations

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

    Masanori Sando, Kay Uehara, Toshisada Aiba, Atsushi Ogura, Tomoki Ebata & Masato Nagino

  2. Department of Public Health, Fujita Health University School of Medicine, Toyoake, Aichi, Japan

    Yuanying Li & Hiroshi Yatsuya

  3. Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yasuhiro Kodera

Authors
  1. Masanori Sando
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  2. Kay Uehara
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  3. Yuanying Li
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  4. Toshisada Aiba
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  5. Atsushi Ogura
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  7. Yasuhiro Kodera
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  8. Hiroshi Yatsuya
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  9. Masato Nagino
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Corresponding author

Correspondence to Kay Uehara.

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Conflict of interest

The authors declare no conflicts of interest in association with the present study.

Ethical statements

This study was approved by the Nagoya University Hospital Institutional Review Board (#2019-0147) and conforms to the provisions of the Declaration of Helsinki.

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Sando, M., Uehara, K., Li, Y. et al. Pelvic exenteration associated with future renal dysfunction. Surg Today 50, 1601–1609 (2020). https://doi.org/10.1007/s00595-020-02036-0

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  • DOI: https://doi.org/10.1007/s00595-020-02036-0

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