Survival among chronic renal failure patients requiring major abdominal surgery.

Overview

BACKGROUND: There is limited literature on survival of patients with chronic renal failure (CRF) who require major abdominal surgery. The goal of the present study was to evaluate indications for surgery and survival among dialysis patients undergoing major abdominal operations. STUDY DESIGN: Medical records for 26 CRF patients at our institution undergoing major nonvascular abdominal operations from 1990 to 1996 were reviewed. Results were evaluated by chi-square analysis. RESULTS: Surgery was performed emergently in 21 patients (81%) and electively in 5 patients (19%). The most common finding among the emergency surgery patients was ischemic colitis, occurring in 9 of 21 patients (43%). Postoperative (30-day) mortality among the emergency surgery patients was 38%. Longterm (1 year) survival was 28%. All 5 patients undergoing elective surgery are alive on followup of 1 to 5 years. The disparity in longterm survival between the emergency surgery versus the elective surgery patients was statistically significant (p = 0.004). CONCLUSIONS: Emergency surgery in patients with CRF is associated with poor survival rates. Colonic ischemia is a significant problem among these patients.