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Esophageal Cancer Surgery in Dialyzed Patients: A Single Institution Case Series
Authors:Masayuki Urabe  Masaki Ueno  Akikazu Yago  Hayato Shimoyama  Yu Ohkura  Shusuke Haruta  Harushi Udagawa
Affiliation:1.Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan;2.Okinaka Memorial Institute for Medical Research, Tokyo, Japan
Abstract:
We sought to evaluate the feasibility of esophageal carcinoma (EC) surgery in cases requiring dialysis. Among 250 consecutive patients undergoing surgical resection for EC, three on maintenance dialysis were identified. We retrospectively analyzed their clinical characteristics. The three dialyzed patients were all males, 39–77 years old at EC surgery. The operations were thoracoscopic esophagectomy with nodal clearance (Case 1), cervical esophageal resection without thoracic procedures (Case 2), and thoracoscopic esophagectomy without reconstruction, emergently conducted for tumor bleeding (Case 3). Reoperation had been required for postoperative abdominal hematoma in Case 1. Postoperative tracheostomy had been performed due to severe pneumonia in Case 2. EC surgery for dialyzed patients, despite appearing to be feasible, might be associated with a high risk of life-threatening morbidities. To minimize surgical risk, therapeutic decision-making for such cases should be based on the balance between radicality and safety.
Keywords:chronic kidney disease   dialysis   esophageal carcinoma   outcome   surgery
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