A Arjona-Sánchez1, A Cadenas-Febres2, J Cabrera-Bermon2, F C Muñoz-Casares3, A Casado-Adam2, J M Sánchez-Hidalgo3, M López-Andreu4, J Briceño-Delgado3, S Rufián-Peña3. 1. Unit of Oncologic and Pancreatic Surgery, University Hospital Reina Sofía, Cordoba, Spain; CIBERehd, IMIBIC, University Hospital Reina Sofía, Cordoba, Spain. Electronic address: alvaroarjona@hotmail.com. 2. Unit of Oncologic and Pancreatic Surgery, University Hospital Reina Sofía, Cordoba, Spain. 3. Unit of Oncologic and Pancreatic Surgery, University Hospital Reina Sofía, Cordoba, Spain; CIBERehd, IMIBIC, University Hospital Reina Sofía, Cordoba, Spain. 4. Unit of Nephrology, University Hospital Reina Sofia, Cordoba, Spain.
Abstract
BACKGROUND: The acute renal dysfunction (ARD) is a common complication in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Our aim is evaluate the ARD post-HIPEC procedures using the RIFLE and AKIN criteria. Evaluate the risk factors and analyze ARD's impact on postoperative course. METHODS: From 2011 to 2014, in a retrospective way using a prospective database were operated by HIPEC procedure. The ARD was analyzed by RIFLE and AKIN criteria. The perioperative features were analyzed and a multivariate analysis was performed to define the risk factors to develop the ARD. RESULTS: 141 patients were treated and analyzed. The ARD was detected in 30.5% (Injury 18.4% and Failure 12.1%) when RIFLE criteria were applied. The multivariate analysis detected that decrease of pH during HIPEC [OR = 29.39 (5.09-169.76)], PCI [OR = 1.07 (1.01-1.15)] and ureteral catheters [OR = 12.71 (1.44-111.85)] were associated to the development of acute renal injury (ARI) post-HIPEC. Decrease of Na during HIPEC [OR = 1.15 (1.01-1.30)], intraoperative inotrope use [OR = 3.83 (1.12-13.09)] and PCI [OR = 1.06 (1.0-1.14)] were associated to acute renal failure (ARF) post-HIPEC. The ARD was related to a higher length of stay hospital (17.2 ± 11 vs. 13.8 ± 8 days) (p = 0.05) but no impact in early survival was observed in ARD group. CONCLUSIONS: The widespread use of RIFLE criteria for ARD would have major benefits in terms of accurately diagnosing patients undergone HIPEC procedures. The ARD has a detrimental impact in length of stay hospital. The knowledge of risk factors helps us to prevent the ARD post-HIPEC by means of an aggressive and multidisciplinary perioperative management.
BACKGROUND: The acute renal dysfunction (ARD) is a common complication in cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC). Our aim is evaluate the ARD post-HIPEC procedures using the RIFLE and AKIN criteria. Evaluate the risk factors and analyze ARD's impact on postoperative course. METHODS: From 2011 to 2014, in a retrospective way using a prospective database were operated by HIPEC procedure. The ARD was analyzed by RIFLE and AKIN criteria. The perioperative features were analyzed and a multivariate analysis was performed to define the risk factors to develop the ARD. RESULTS: 141 patients were treated and analyzed. The ARD was detected in 30.5% (Injury 18.4% and Failure 12.1%) when RIFLE criteria were applied. The multivariate analysis detected that decrease of pH during HIPEC [OR = 29.39 (5.09-169.76)], PCI [OR = 1.07 (1.01-1.15)] and ureteral catheters [OR = 12.71 (1.44-111.85)] were associated to the development of acute renal injury (ARI) post-HIPEC. Decrease of Na during HIPEC [OR = 1.15 (1.01-1.30)], intraoperative inotrope use [OR = 3.83 (1.12-13.09)] and PCI [OR = 1.06 (1.0-1.14)] were associated to acute renal failure (ARF) post-HIPEC. The ARD was related to a higher length of stay hospital (17.2 ± 11 vs. 13.8 ± 8 days) (p = 0.05) but no impact in early survival was observed in ARD group. CONCLUSIONS: The widespread use of RIFLE criteria for ARD would have major benefits in terms of accurately diagnosing patients undergone HIPEC procedures. The ARD has a detrimental impact in length of stay hospital. The knowledge of risk factors helps us to prevent the ARD post-HIPEC by means of an aggressive and multidisciplinary perioperative management.
Authors: A Arjona-Sánchez; P Barrios; E Boldo-Roda; B Camps; J Carrasco-Campos; V Concepción Martín; A García-Fadrique; A Gutiérrez-Calvo; R Morales; G Ortega-Pérez; E Pérez-Viejo; A Prada-Villaverde; J Torres-Melero; E Vicente; P Villarejo-Campos; J M Sánchez-Hidalgo; A Casado-Adam; Ruben García-Martin; Manuel Medina; T Caro; C Villar; Enrique Aranda; M T Cano-Osuna; C Díaz-López; E Torres-Tordera; F J Briceño-Delgado; S Rufián-Peña Journal: BMC Cancer Date: 2018-02-13 Impact factor: 4.430
Authors: Angela Casado-Adam; Lidia Rodriguez-Ortiz; Sebastian Rufian-Peña; Cristobal Muñoz-Casares; Teresa Caro-Cuenca; Rosa Ortega-Salas; Maria Auxiliadora Fernandez-Peralbo; Maria Dolores Luque-de-Castro; Juan M Sanchez-Hidalgo; Cesar Hervas-Martinez; Antonio Romero-Ruiz; Javier Briceño; Álvaro Arjona-Sánchez Journal: J Clin Med Date: 2022-09-29 Impact factor: 4.964
Authors: Lukas F Liesenfeld; Benedikt Wagner; H Christian Hillebrecht; Maik Brune; Christoph Eckert; Johannes Klose; Thomas Schmidt; Markus W Büchler; Martin Schneider Journal: Ann Surg Oncol Date: 2021-07-14 Impact factor: 5.344