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The Influence of the Fast-Track Program on the Functional State of Kidneys in Patients with Chronic Kidneys Pathology at Simultane Treatment of Combined Surgical Diseases of Organs of Abdominal Cavity and Anterior Abdominal Wall


Affiliations
1 Department of Surgery No 1, Medical Academy named after S.I. Georgievsky of V. I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
2 Department of Internal Medicine No 2, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
3 Department of Psychiatry, Narcology, Psychotherapy with the Course of General and Medical Psychology, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
4 Department of General Surgery, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
     

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The aim of the study was to study the functional state of the kidneys in patients with chronic renal insufficiency in the postoperative period after simultaneous operations of cholecystectomy and hernioplasty using the "Fast-track" program. The work was based on the analysis of renal function and renal blood flow in 78 patients with chronic renal failure who underwent simultaneous laparoscopic surgeries. In 1 group included 38 (48.7%) patients operated with the application of the program "Fast-track"; Group 2 comprised 40 (51.3%) patients operated without the Fast-Track program. All the patients before the operation, on the 3rd and the 7th day after the operation, underwent a clinical and laboratory study with the study of serosity level of creatinine, cystatin C, daily protein excretion, rate of glomerular filtration and dopplerometric blood flow parameters of the renal arteries and segmental renal arteries. In patients with chronic renal insufficiency, an impaired renal function occurs in the early postoperative period, which is manifested by a decrease in the filtration function (an increase in glomerular filtration rate, creatinine and cystatin C), an increase in daily protein excretion, and is accompanied by changes in renal artery blood flow with a decrease in maximum systolic velocity, and an increase in resistance indices. Changes in renal blood flow can create conditions for impaired renal perfusion and impaired renal function in patients with chronic renal failure. At the same time, the introduction of the Fast-track program led to a decrease in the severity of these negative stress changes in kidney function on day 3 after surgery and an increase in the rate of recovery of blood flow to preoperative, which was observed on day 7 and was associated with restoration of the function of the kidney preoperative. The introduction of the "Fast-track" program in patients with chronic renal failure with simultaneous operations on the abdominal cavity is accompanied by a decrease in the stress reaction of renal blood flow and improvement of tissue perfusion, which accompanies the acceleration of the restoration of kidney function in the postoperative period.

Keywords

Simultaneous Operations, Renal Blood Flow, Creatinine, Cystatin C, Ultrasonic Dopplerometry, Glomerular Filtration Rate, Daily Protein Excretion.
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  • The Influence of the Fast-Track Program on the Functional State of Kidneys in Patients with Chronic Kidneys Pathology at Simultane Treatment of Combined Surgical Diseases of Organs of Abdominal Cavity and Anterior Abdominal Wall

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Authors

Oksana Yu. Gerbali
Department of Surgery No 1, Medical Academy named after S.I. Georgievsky of V. I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
Andrey V. Petrov
Department of Internal Medicine No 2, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
Aleksandr V. Kostyrnoy
Department of Surgery No 1, Medical Academy named after S.I. Georgievsky of V. I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
Lesya N. Gumenyuk
Department of Psychiatry, Narcology, Psychotherapy with the Course of General and Medical Psychology, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation
Usein I. Basnaev
Department of General Surgery, Medical Academy named after S.I. Georgievsky of V.I. Vernadsky Crimean Federal University, Simferopol, Russian Federation

Abstract


The aim of the study was to study the functional state of the kidneys in patients with chronic renal insufficiency in the postoperative period after simultaneous operations of cholecystectomy and hernioplasty using the "Fast-track" program. The work was based on the analysis of renal function and renal blood flow in 78 patients with chronic renal failure who underwent simultaneous laparoscopic surgeries. In 1 group included 38 (48.7%) patients operated with the application of the program "Fast-track"; Group 2 comprised 40 (51.3%) patients operated without the Fast-Track program. All the patients before the operation, on the 3rd and the 7th day after the operation, underwent a clinical and laboratory study with the study of serosity level of creatinine, cystatin C, daily protein excretion, rate of glomerular filtration and dopplerometric blood flow parameters of the renal arteries and segmental renal arteries. In patients with chronic renal insufficiency, an impaired renal function occurs in the early postoperative period, which is manifested by a decrease in the filtration function (an increase in glomerular filtration rate, creatinine and cystatin C), an increase in daily protein excretion, and is accompanied by changes in renal artery blood flow with a decrease in maximum systolic velocity, and an increase in resistance indices. Changes in renal blood flow can create conditions for impaired renal perfusion and impaired renal function in patients with chronic renal failure. At the same time, the introduction of the Fast-track program led to a decrease in the severity of these negative stress changes in kidney function on day 3 after surgery and an increase in the rate of recovery of blood flow to preoperative, which was observed on day 7 and was associated with restoration of the function of the kidney preoperative. The introduction of the "Fast-track" program in patients with chronic renal failure with simultaneous operations on the abdominal cavity is accompanied by a decrease in the stress reaction of renal blood flow and improvement of tissue perfusion, which accompanies the acceleration of the restoration of kidney function in the postoperative period.

Keywords


Simultaneous Operations, Renal Blood Flow, Creatinine, Cystatin C, Ultrasonic Dopplerometry, Glomerular Filtration Rate, Daily Protein Excretion.

References