Possibilities and Prospects for Preserving Peritoneal Dialysis in Patients With Chronic Kidney Disease Who Need Surgical Interventions on the Abdominal Organs

Introduction. Laparoscopic surgery is increasingly being used in various combined diseases, including in patients with chronic kidney disease on peritoneal dialysis. One of the absolute contraindications to the preparation and further treatment with outpatient peritoneal dialysis is the presence of a surgical history, as well as a diagnosed oncological process of the abdominal organs. Previously, the need for surgical intervention for colorectal cancer provided for the irrevocable completion of peritoneal dialysis in the treatment of a patient with CKD and transfer to programmatic hemodialysis.

The purpose of the study. Preservation of programmatic peritoneal dialysis in patients with terminal chronic renal failure after laparoscopic hemicolectomy with lymph node dissection for colon cancer.

Materials and methods. The search for keywords of literary sources in the international abstract database was carried out PubMed.gov , as well as the Russian RSCI system for the last 20 years with subsequent analysis. 2 patients with dialysis-related stage 5 chronic disease and colon adenocarcinomas are presented. Both patients underwent radical surgical treatment for a colon tumor while maintaining programmatic peritoneal dialysis.

Discussion. These clinical observations demonstrate that laparoscopic hemicolectomy on the left can be performed safely, providing the patient with the benefits of a minimally invasive approach and keeping it on PD. Our proposed surgical technique is a promising alternative for this group of patients, which makes it possible to continue treatment with peritoneal dialysis in the postoperative period.

Conclusions. A multidisciplinary approach combining modern laparoscopic operations, compliance with oncological principles and balanced nephrological tactics can represent a reasonable, safe strategy for surgical treatment of operable forms of colon cancer with the possibility of maintaining PD in the postoperative period.

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