Objective The purpose of this study was to explore the feasibility and the perioperative management of surgical treatment due to concomitant diseases in patients with maintenance peritoneal dialysis (MPD). Methods All peritoneal dialysis patients treated in Peking University People's Hospital from March 2006 to May 2021 were enrolled in this study, and the surgical operation records were reviewed for retrospective study. General information of the operation, levels of hemoglobin, electrolyte, renal function, blood pressure and others before and after the operation for 1-3 days, and surgical complications were recruited. Perioperative management and dialysis program were then explored in the MPD patients. Results In the 513 MPD patients, 72 (14.0%) patients required 96 operations for various concomitant diseases, and 71 operations involved in 11 departments were analyzed in this study. Hemoglobin (100.15±14.95 vs. 106.15±14.95 g/L, t=3.436, P=0.001), serum albumin (32.45±5.14 vs. 34.99±5.14, t=3.362, P=0.002) and carbon dioxide binding capacity (25.30±3.66 vs. 27.04±2.76, t=4.205, P＜0.001) decreased but still within the target ranges after the operations as compared with those before the operations. Blood pressure and serum potassium had no changes after the operations. Patients used general anesthesia had a higher probability (58.3%) of switching to continuous renal replacement therapy (CRRT) or hemodialysis during perioperative period than those used local anesthesia and intra-spinal anesthesia. Antibiotics were routinely used in 18 operations, and iodine contrast agent was used in 25 operations. Postoperative peritonitis occurred in 2 cases. The prognosis was better in most cases except that one patient died within one week after the operation. Conclusion There are higher risks in MPD patients undertaking surgical operation. However, most patients tolerate the surgery if perioperative management is appropriately arranged. Management of perioperative period, especially the adjustment of dialysis program, must be emphasized to help patients safely go through the perioperative period.
WU Bei
,
ZHAO Hui-Ping
,
TANG Yi-Fang
,
LU Li-Xia
,
QIAO Jie
,
ZUO Li
,
WANG Mei
. Feasibility of the surgery unrelated to peritoneal dialysis in peritoneal dialysis patients[J]. Chinese Journal of Blood Purification, 2023
, 22(03)
: 173
-176
.
DOI: 10.3969/j.issn.1671-4091.2023.03.004
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