Renal outcomes following left renal vein harvest for venous reconstruction during pancreas and liver surgery
| Autor: | Sangita Sequeira, Robin Visser, Benjamin Loveday, Martin J. Dib, Alice C. Wei, Nouf Alotaiby, Carol-Anne Moulton, Andrew S. Barbas, Paul D. Greig, Sean P. Cleary, Ian D. McGilvray, Steven Gallinger |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Time Factors Adolescent Urology Renal function 030230 surgery urologic and male genital diseases Risk Assessment Renal Veins Pancreaticoduodenectomy Young Adult 03 medical and health sciences chemistry.chemical_compound Pancreatectomy 0302 clinical medicine Risk Factors Hepatectomy Humans Medicine Renal Insufficiency Chronic Risk factor Young adult Aged Retrospective Studies Aged 80 and over Creatinine Hepatology business.industry Gastroenterology Acute kidney injury Retrospective cohort study Acute Kidney Injury Middle Aged medicine.disease Treatment Outcome medicine.anatomical_structure chemistry 030220 oncology & carcinogenesis Tissue and Organ Harvesting Female business Pancreas Biomarkers Glomerular Filtration Rate Kidney disease |
| Zdroj: | HPB. 21:114-120 |
| ISSN: | 1365-182X |
| Popis: | Background The left renal vein (LRV) may be used for venous reconstruction during hepato-pancreato-biliary (HPB) surgery, although concerns exist about compromising renal function. This study aimed to determine renal outcomes following LRV harvest during HPB resections. Methods Circumferential PV/SMV resections from 2008 to 2014 were included within two groups (LRV harvest, Control). Absolute and change in Creatinine (Cr) and estimated GFR (eGFR), and rates of acute kidney injury (AKI) and chronic kidney disease (CKD), were compared. Multivariate logistic regression analyses were performed. Results 76 patients were included (LRV n = 17, Control n = 59). Median Cr and eGFR did not change within groups, although change in eGFR differed between groups at postoperative day (POD) 3 (−4.3 vs. 12.8, p = 0.0035) and 7 (−1.8 vs. 12.4, p = 0.0074). AKI occurred more frequently in the LRV group at POD1 (5/17 vs. 4/59, p = 0.023) and POD3 (5/17 vs. 3/59, p = 0012), with no difference in CKD between groups (2/11 vs. 5/33 at 3 months, p = 0.99). LRV harvest was an independent risk factor for AKI at POD1 and POD3, but not thereafter. Conclusions Patients who undergo LRV harvest experience a higher rate of AKI in the first three post-operative days. LRV harvest during pancreas resection does not impact on long-term renal function. |
| Databáze: | OpenAIRE |
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