Postoperative acute renal failure in patients with gynecologic malignancies: analysis of 10 cases and review of the literature

다국어 초록 (Multilingual Abstract)

Objective: Postoperative acute renal failure (PO-ARF) is an important cause of mortality among surgical patients.
Although there have been many reports on PO-ARF after cardiac surgery and liver transplantation, less is known
about the risk of PO-ARF after gynecologic operations. We aimed to investigate the risk of PO-ARF on gynecologic
malignancy operations.
Methods: 1,155 patients’ medical charts were reviewed who underwent therapeutic surgery for gynecologic malignancies
from January 1, 2005 to December 31, 2007, at the Asan Medical Center, Seoul, Korea.
Results: Of these, 10 patients, comprising 0.89% of those who underwent radical hysterectomies and 0.86% of those
who underwent debulking operations, were diagnosed with PO-ARF. Their mean age was 61.9±10.1 years. Five
patients had preoperative risk factors. Mean operating time was 360.8±96.2 minutes. Five patients experienced
intra-operative hypotension and all patients were given blood transfusions during surgery. Eight patients underwent
hemodialysis, with two continuing on dialysis to date. Only two patients fully recovered.
Conclusion: Patients undergoing surgery for gynecologic malignancies may be at high risk for PO-ARF, because of old
age, long operation times, and profuse bleeding. It is necessary to monitor these patients for postoperative renal
function and urine output. If a postoperative oliguric state is detected, aggressive volume expansion should be started
immediately, followed by hemodialysis.

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