| Theme | Disease of Liver, Gallbladder, Spleen, and Pancreas in Dialysis Patients | |
|---|---|---|
| Title | Surgery for hepatocellular carcinoma in hemodialysis patients | |
| Publish Date | 2002/06 | |
| Author | Yo Sasaki | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Terumasa Yamada | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Hiroaki Ohigashi | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Yuichiro Doki | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Masao Kameyama | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Masahiro Hiratsuka | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Osamu Ishikawa | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| Author | Shingi Imaoka | Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases |
| [ Summary ] | Backgrounds and perioperative management were evaluated for those patients with hepatocellular carcioma, who were receiring hemodialysis and undergone had surgery. 22 patients in 6 hospitals were selected from the literatures. The median age was 55.5 years, and the ratio of male patients was 86%. Half of the patients underwent surgery within one year from the start of hemodialysis. The frequency of patients without viral hepatitis was relatively high, 27%, and that of the patients with good liver functions was also relatively high. The most important point of intraoperative management is the stability of circulatory movement. From the standpoint of surgical sites, less invasive surgery is recommended, and from that of anesthetic sites, close monitoring, low-dose catecholamine and potassium-free infusion are done. Concerning the major complications in the days following surgery, persistent infections and gastrointestinal bleeding occur with high frequency. Prevention is more important than treatment for these complications. | |