Purpose: There are steadily increasing number of patients with end-stage renal disease in dialysis and renal transplants. A few reports described the outcome of patients in dialysis those undergoing major abdominal surgery, but in renal transplants such a report has not been reported.
Methods: We reviewed 43 patients who underwent major abdominal surgery including 22 patients undergoing dialysis (dialysis group), 7 patients undergoing dialysis with rejected renal transplants (rejected group), and 14 renal transplant with graft function (transplanted group).
Results: Emergency operation was performed in 24 (55.8%) patients : 12 in dialysis group, 5 in rejected group, and 7 in transplanted group, The indication of surgery included malignant disease in 16 (37.2%), bowel perforation in 9 (20.9%), adhesive ileus in 5 (11.6%), gastrointestinal bleeding in 4 (9.3%) and etc. The operative mortality rate was 25.6% (11/43) and developed all in emergency surgery including 2 in dialysis group (9.1% : 2/22), 4 in rejected group (57.1% : 4/11), and 5 in transplanted group (35.7% : 5/14). The most common diseases in operative mortality cases were bowel perforation in 4 and gastrointestinal bleeding in 3, The cause of death were sepsis in 5, and, pneumonia, heart failure, and disseminated intravascular coagulation in 2, respectively.
Conclusion: The emergency major abdominal surgery in patients with renal transplantation and with rejected renal transplantation patients has high operative mortality rates than that of dialysis patients.
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