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