Abstract：
OBJECTIVE: Temporary ileostomy is sometimes created after colorectal surgery and may cause renal impairment. However, the impact of ileostomy on renal function during adjuvant chemotherapy for colorectal cancer (CRC) remains unknown. The aim of the present study was to examine the effects of ileostomy on renal function during adjuvant chemotherapy.
METHODS: We examined 184 patients who received adjuvant CAPOX therapy (capecitabine and oxaliplatin) for CRC with or without ileostomy between January 2011 and December 2020 at the University of Tokyo Hospital. Clinicopathological factors, including renal function, were retrospectively reviewed in association with temporary ileostomy. Factors associated with reductions in the estimated glomerular filtration rate (eGFR) during CAPOX therapy were analyzed.
RESULTS: Eighteen patients (10%) underwent temporary ileostomy. The maximum decrease in eGFR during CAPOX therapy was significantly higher in patients with than in those without ileostomy (- 16.1 vs. - 5.6 mL/min/1.73m2, p = 0.003). A multivariate analysis identified ileostomy as one of factors independently associated with reductions in eGFR during CAPOX therapy (p = 0.003). The cumulative number of readmission due to dehydration was also higher in patients with ileostomy (33% vs. 1%, p < 0.001).
CONCLUSIONS: Ileostomy significantly reduced eGFR during adjuvant CAPOX therapy. Therefore, renal function needs to be monitored during CAPOX therapy, particularly in patients with ileostomy.
METHODS: We examined 184 patients who received adjuvant CAPOX therapy (capecitabine and oxaliplatin) for CRC with or without ileostomy between January 2011 and December 2020 at the University of Tokyo Hospital. Clinicopathological factors, including renal function, were retrospectively reviewed in association with temporary ileostomy. Factors associated with reductions in the estimated glomerular filtration rate (eGFR) during CAPOX therapy were analyzed.
RESULTS: Eighteen patients (10%) underwent temporary ileostomy. The maximum decrease in eGFR during CAPOX therapy was significantly higher in patients with than in those without ileostomy (- 16.1 vs. - 5.6 mL/min/1.73m2, p = 0.003). A multivariate analysis identified ileostomy as one of factors independently associated with reductions in eGFR during CAPOX therapy (p = 0.003). The cumulative number of readmission due to dehydration was also higher in patients with ileostomy (33% vs. 1%, p < 0.001).
CONCLUSIONS: Ileostomy significantly reduced eGFR during adjuvant CAPOX therapy. Therefore, renal function needs to be monitored during CAPOX therapy, particularly in patients with ileostomy.
摘要：
目的：临时回肠造口术有时是在结直肠手术后进行的，可能会引起肾功能损害。然而,结直肠癌(CRC)辅助化疗期间回肠造口术对肾功能的影响尚不清楚.本研究的目的是检查辅助化疗期间回肠造口术对肾功能的影响。
方法：我们在2011年1月至2020年12月期间在东京大学医院检查了184名接受CAPOX辅助治疗（卡培他滨和奥沙利铂）的CRC伴或不伴回肠造口的患者。临床病理因素,包括肾功能,与临时回肠造口术相关的回顾性研究。分析了CAPOX治疗期间与估计肾小球滤过率（eGFR）降低相关的因素。
结果：18例患者（10%）接受了临时回肠造口术。CAPOX治疗期间eGFR的最大下降明显高于未进行回肠造口术的患者（-16.1vs.-5.6mL/min/1.73m2,p=0.003)。多变量分析确定回肠造口术是CAPOX治疗期间eGFR降低的独立相关因素之一(p=0.003)。回肠造口术患者因脱水而再次入院的累积次数也较高(33%vs.1%,p<0.001)。
结论：回肠造口术在辅助CAPOX治疗期间显著降低eGFR。因此,CAPOX治疗期间需要监测肾功能，尤其是回肠造口术患者。
方法：我们在2011年1月至2020年12月期间在东京大学医院检查了184名接受CAPOX辅助治疗（卡培他滨和奥沙利铂）的CRC伴或不伴回肠造口的患者。临床病理因素,包括肾功能,与临时回肠造口术相关的回顾性研究。分析了CAPOX治疗期间与估计肾小球滤过率（eGFR）降低相关的因素。
结果：18例患者（10%）接受了临时回肠造口术。CAPOX治疗期间eGFR的最大下降明显高于未进行回肠造口术的患者（-16.1vs.-5.6mL/min/1.73m2,p=0.003)。多变量分析确定回肠造口术是CAPOX治疗期间eGFR降低的独立相关因素之一(p=0.003)。回肠造口术患者因脱水而再次入院的累积次数也较高(33%vs.1%,p<0.001)。
结论：回肠造口术在辅助CAPOX治疗期间显著降低eGFR。因此,CAPOX治疗期间需要监测肾功能，尤其是回肠造口术患者。
