계명대학교 의학도서관 Repository

Renal outcomes of laparoscopic versus open surgery in patients with rectal cancer: a propensity score analysis

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Author(s)
Jin Hyuk PaekSung Il KangJiwon RyuSung Yoon LimJi Young RyuHyung Eun SonJong Cheol JeongHo Jun ChinKi Young NaDong-Wan ChaeSung-Bum KangSejoong Kim
Keimyung Author(s)
Paek, Jin Hyuk
Department
Dept. of Internal Medicine (내과학)
Journal Title
Kidney Res Clin Pract
Issued Date
2021
Volume
40
Issue
4
Keyword
Acute kidney injury, Colorectal surgery, Laparoscopy, Rectal neoplasms
Abstract
Background:
A laparoscopic approach is widely used in abdominal surgery. Although several studies have compared surgical and oncological outcomes between laparoscopic surgery (LS) and open surgery (OS) in rectal cancer patients, there have been few studies on postoperative renal outcomes.

Methods:
We conducted a retrospective cohort study involving 1,633 patients who underwent rectal cancer surgery between 2003 and 2017. Postoperative acute kidney injury (AKI) was diagnosed according to the serum creatinine criteria of the Kidney Disease: Improving Global Outcomes classification.

Results:
Among the 1,633 patients, 1,072 (65.6%) underwent LS. After matching propensity scores, 395 patients were included in each group. The incidence of postoperative AKI in the LS group was significantly lower than in the OS group (9.9% vs. 15.9%; p = 0.01). Operation time, estimated blood loss, and incidence of transfusion in the LS group were significantly lower than those in the OS group. Cox proportional hazard models revealed that LS was associated with decreased risk of postoperative AKI (hazard ratio [HR], 0.599; 95% confidence interval [CI], 0.402-0.893; p = 0.01) and postoperative transfusion was associated with increased risk of AKI (HR, 2.495; 95% CI, 1.529-4.072; p < 0.001). In the subgroup analysis, the incidence of postoperative AKI in patients with middle or high rectal cancer who underwent LS was much lower than in those who underwent OS (HR, 0.373; 95% CI, 0.197-0.705; p = 0.002).

Conclusion:
This study showed that LS may have a favorable effect on the development of postoperative AKI in patients with rectal cancer.
Keimyung Author(s)(Kor)
백진혁
Publisher
School of Medicine (의과대학)
Citation
Jin Hyuk Paek et al. (2021). Renal outcomes of laparoscopic versus open surgery in patients with rectal cancer: a propensity score analysis. Kidney Res Clin Pract, 40(4), 634–644. doi: 10.23876/j.krcp.21.002
Type
Article
ISSN
2211-9140
Source
https://www.krcp-ksn.org/journal/view.php?doi=10.23876/j.krcp.21.002
DOI
10.23876/j.krcp.21.002
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43867
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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