Impact of pretreatment asymptomatic renal dysfunction on clinical course after esophagectomy

Surg Today. 2021 Jan;51(1):165-171. doi: 10.1007/s00595-020-02118-z. Epub 2020 Aug 29.

Abstract

Purpose: Recent large-scale clinical studies have shown that preoperative renal insufficiency is associated with an increased risk of postoperative complications after esophagectomy; however, it remains unclear whether asymptomatic renal dysfunction affects the postoperative course after esophagectomy.

Methods: The subjects of this retrospective study were 177 patients who underwent esophagectomy between May, 2009 and December, 2018. Renal function was evaluated based on the pretreatment estimated glomerular filtration rate (eGFR). Patients were divided into two groups according to the eGFR cut-off value of 55 ml/min per 1.73 m2.

Results: There were 17 patients in the low eGFR group and 160 patients in the normal group eGFR group. The rate of severe complications was significantly higher in the low eGFR than in the normal eGFR group. A low eGFR was the only significant complication risk factor identified; however, there were no marked differences in mortality or survival between the low and normal eGFR groups.

Conclusion: Our findings demonstrate that pretreatment asymptomatic renal dysfunction may be a significant risk factor for severe morbidity after esophagectomy.

Keywords: Esophagectomy; Postoperative complication; Renal dysfunction; Surgery.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Asymptomatic Diseases*
  • Esophagectomy / adverse effects*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Morbidity
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Preoperative Period
  • Renal Insufficiency / complications*
  • Renal Insufficiency / epidemiology
  • Renal Insufficiency / physiopathology
  • Retrospective Studies
  • Risk
  • Risk Factors