Surgical treatments and outcomes for colorectal carcinoma in patients on hemodialysis

Abstract

We clinically studied consecutive 20 patients on hemodialysis undergoing surgery for colorectal carcinoma in our hospital from March 2003 through September 2010. Of these 20 patients, 18 patients underwent elective surgery and the remaining two, emergency surgery. Operative procedures included laparotomy in 16 patients, laparoscopic-assisted surgery in three, and laparotomy shifted from laparoscopic surgery in one. Radical operation was able to be done in all the patients. Reconstruction was made in 19 and colostomy was done in only one emergency case. Postoperative complications occurred in five (25%) patients and were conservatively treated. The survival rates in hemodialysis patients with colorectal cancer were compatible with the general population when the death cases due to other diseases were excluded. Surgery for malignant colorectal tumors has been widely performed safely even in patients who are receiving maintenance hemodialysis. However, it is thought that dialysis patients are still in a high risk group because of increases in the number of elderly patients, as well as patients with many complications such as diabetes mellitus and coronary artery diseases, and the long duration of hemodialysis therapy. Better outcomes after surgical treatment for hemodialysis patients with colorectal cancer rely on meticulous and intensive perioperative care, in addition to positive surveillance and early diagnosis.