Abdominal surgery in patients undergoing long-term peritoneal dialysis

F. L. Moffat, M. Deitel, D. A. Thompson

Research output: Contribution to journalArticle

34 Scopus citations

Abstract

Nineteen patients undergoing long-term peritoneal dialysis (LTPD) required abdominal operations - 11 elective and 8 emergency. The preoperative hemoglobin level was 9.0 ± 2.6 gm/dl, and the serum albumin was 28.8 ± 4.9 gm/L. There was one death in the elective group (an inguinal herniorrhaphy) and four deaths in the emergency group (three spontaneous colonic perforations and one strangulated ventral hernia). Wound complications occurred in five patients. To obtain an indication of nutritional status of patients on intermittent LTPD and high-protein diets, 17 in-center patients underwent nutritional assessment, and deficiencies in delayed hypersensitivity skin testing and total lymphocyte counts were prevalent. Wounds require secure, watertight closure to prevent dialysis leakage. In elective abdominal surgery, LTPD should be carried out shortly preoperatively to delay dialysis for a few days after operation and to decrease defective platelet function. Preoperative transfusion for anemia is generally unnecessary. Drains should be avoided or removed before resumption of LTPD. Abdominal wall hernias should be repaired electively. Constipation should be avoided. Marked protein loss accompanies peritonitis. In certain instances, transfer to hemodialysis is indicated.

Original languageEnglish (US)
Pages (from-to)598-604
Number of pages7
JournalSurgery
Volume92
Issue number4
StatePublished - Dec 1 1982

    Fingerprint

ASJC Scopus subject areas

  • Surgery

Cite this

Moffat, F. L., Deitel, M., & Thompson, D. A. (1982). Abdominal surgery in patients undergoing long-term peritoneal dialysis. Surgery, 92(4), 598-604.