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KMID : 1137020090200010055
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Journal of Gynecologic Oncology
2009 Volume.20 No. 1 p.55 ~ p.59
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Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature
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Han Ae-Ra
Suh Dae-Sik
Kim Jong-Hyeok
Kim Dae-Yeon
Kim Yong-Man
Kim Young-Tak
Nam Joo-Hyun
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Abstract
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Objectives: Postoperative acute renal failure (PO-ARF) is an important cause of mortality among surgical patients. Although there have been many reports on PO-ARF after cardiac surgery and liver transplantation, less is known about the risk of PO-ARF after gynecologic operations. We aimed to investigate the risk of PO-ARF on gynecologic malignancy operations.
Methods: 1,155 patients’ medical charts were reviewed who underwent therapeutic surgery for gynecologic malignancies from January 1, 2005 to December 31, 2007, at the Asan Medical Center, Seoul, Korea.
Results: Of these, 10 patients, comprising 0.89% of those who underwent radical hysterectomies and 0.86% of those who underwent debulking operations, were diagnosed with PO-ARF. Their mean age was 61.9±10.1 years. Five patients had preoperative risk factors. Mean operating time was 360.8±96.2 minutes. Five patients experienced intra-operative hypotension and all patients were given blood transfusions during surgery. Eight patients underwent hemodialysis, with two continuing on dialysis to date. Only two patients fully recovered.
Conclusion: Patients undergoing surgery for gynecologic malignancies may be at high risk for PO-ARF, because of old age, long operation times, and profuse bleeding. It is necessary to monitor these patients for postoperative renal function and urine output. If a postoperative oliguric state is detected, aggressive volume expansion should be started immediately, followed by hemodialysis.
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KEYWORD
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Postoperative acute renal failure, Gynecologic malignancy
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