Abstract
We performed 26 operations for the 25 patients whose lives were sustained by hemodialysis.
Among 26 operations 20 were performed for benign diseases and 6 for the malignancies.
The operative mortality of the benign diseases was 5%, but that of the malignancies was as high as 33%.
The main causes of operative death of malignancies were anastomotic insufficiency and pulmonary complications.
As the countermeasure of anastomotic insufficiency we tried (1) to reduce the number of anastomosis between intestines and (2) to avoid the use of suture machine to reduce the tissue lesion around the anastomotic site and (3) to use non-absorbable atraumatic needle.
To prevent the pulmonary complications, especially in the older patients, we tried to use the respirator until they awoke from anesthesia so clearly that they could expectorate sputa completely by themselves and we made jejunostomia from which we inserted the gastric tube and advanced it retrogradely to the rest of stomach, aiming to facilitate expectoration by making the upper airway free from the gastric tube.
