Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature.
- Author:
Ae Ra HAN
1
;
Dae Yeon KIM
;
Dae Sik SUH
;
Jong Hyeok KIM
;
Yong Mam KIM
;
Young Tak KIM
;
Joo Hyun NAM
Author Information
- Publication Type:Original Article
- Keywords: Postoperative acute renal failure; Gynecologic malignancy
- MeSH: Acute Kidney Injury; Blood Transfusion; Dialysis; Hemorrhage; Humans; Hypotension; Hysterectomy; Korea; Liver Transplantation; Organothiophosphorus Compounds; Renal Dialysis; Risk Factors; Thoracic Surgery
- From:Journal of Gynecologic Oncology 2009;20(1):55-59
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: 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.
