title: Laparoscopic Left Hemicolectomy for Colon Cancer in Peritoneal Dialysis Patients: A Valid and Safe Surgical Technique to Ensure Peritoneal Dialysis Survival.
abstract: A laparoscopic approach represents an effective alternative to open surgery in patients undergoing peritoneal dialysis (PD). In these patients, conventional thinking provides for removal of the peritoneal catheter during left colon resections because of higher risk of patient contamination and peritonitis. The present paper describes 3 cases of laparoscopic left hemicolectomy for colon cancer performed in PD patients without complications and without peritoneal catheter removal, leading to subsequent early PD resumption.Three normotype PD patients affected by early-stage sigmoid colon adenocarcinoma (T1-T2, M0, N0) underwent integrated surgical and nephrological management to reduce peritoneum stress, infective risk and postoperative complications. The day before surgery, patients were shifted to isovolumetric hemodialysis through tunneled central venous catheter. All patients underwent laparoscopic left hemicolectomy without Tenckhoff catheter removal. The postoperative period was uneventful, with concomitant antibiotic prophylaxis until the fifth day after surgery. Flushing of the PD catheter was performed twice a week postoperatively. Peritoneal dialysis was recovered 4 weeks after surgery in 2 cases with a well-maintained dialytic adequacy. One patient did not proceed to PD due to improvement of renal function after surgery.In selected PD patients, a minimally invasive surgical approach combined with careful nephrological management may represent a valid and safe strategy to treat early-stage colon cancer, avoiding PD drop-out.
authors.affiliation: Renal and Dialysis Unit, AO Desio-Vimercate, Desio, Italy sara.auricchio@aovimercate.org.
authors.forename: Sara
authors.initials: S
authors.lastname: Auricchio
authors.affiliation: Division of Surgery, AO Desio-Vimercate, Desio, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Mari
authors.affiliation: Renal and Dialysis Unit, AO Desio-Vimercate, Desio, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Galassi
authors.affiliation: Renal and Dialysis Unit, AO Desio-Vimercate, Desio, Italy.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Dozio
authors.affiliation: Renal and Dialysis Unit, AO Desio-Vimercate, Desio, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pozzi
authors.affiliation: Division of Surgery, AO Desio-Vimercate, Desio, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Maggioni
authors.affiliation: Renal and Dialysis Unit, AO Desio-Vimercate, Desio, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Scanziani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D010530:Peritoneal Dialysis / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Catheter removal; colon cancer; laparoscopic hemicolectomy; peritoneal dialysis management