Resection, haemodialysis in colon cancer patients tied to higher postoperative complication risk

In colon cancer patients receiving curative surgery, undergoing haemodialysis still carries a high risk of postoperative complications despite advancements in perioperative management, a recent study has found.

Researchers conducted a retrospective analysis of 1,372 patients, of whom 1.4 percent (n=19; median age 77 years, 52.6 percent men) underwent haemodialysis while 4.3 percent (n=59; median age 81 years, 59.3 percent men) had renal dysfunction. Most patients had poor performance status (68.0 percent) or preoperative comorbidities (63.7 percent).

Laparoscopic surgery was the top procedure, performed in 85.5 percent of the overall sample. The median operative time was 211 minutes, during which a median of 25 mL of blood lost.

Postoperative complications occurred in 236 patients overall, yielding an incidence rate of 17.2 percent. Patients undergoing haemodialysis saw a much greater postoperative complication rate than comparators with renal dysfunction or who had normal renal function (36.8 percent vs 18.6 percent and 16.8 percent).

Multivariate logistic regression analysis confirmed that haemodialysis was a significant and independent correlate of postoperative complications, raising such likelihood by nearly three times (odds ratio, 2.9362, 95 percent confidence interval, 1.1384–7.5730; p=0.026).

Notably, all complications in haemodialysis patients were infectious in nature, including anastomotic leak (n=3), pneumonia (n=1), surgical site infection (n=1), and urinary tract infection (n=1).

“As advances in perioperative management and minimally invasive surgery have become mainstream, it is necessary to remain aware that short-term complications can occur, especially infectious complications in haemodialysis patients,” the researchers said.