Our Summary

This research paper looks at the occurrence, causes, and implications of acute kidney injury (AKI) following general chest (thoracic) surgery. The researchers looked at several studies conducted from 2004 to 2021, which included over 50 patients who had thoracic surgery and reported kidney injury afterwards.

The study found that in a group of 58,140 patients, about 8.0% experienced AKI after the surgery. The type of surgery had an impact on the rate of AKI, with more complex surgeries like the removal of a lung (pneumonectomy) or part of the esophagus (esophagectomy) having higher rates of AKI.

The study also found that patients who had kidney injury after surgery had a higher risk of dying in the short term and spent more time in the hospital. The researchers identified several risk factors for developing AKI after chest surgery.

In conclusion, the study suggests that AKI is a common occurrence after thoracic surgery and it increases the risk of death and length of hospital stay. Therefore, it is important to assess the risk of AKI before surgery and take measures to prevent it.

FAQs

  1. What is the occurrence rate of acute kidney injury (AKI) after thoracic surgery according to the research?
  2. Does the type of thoracic surgery have an impact on the rate of AKI?
  3. What are the implications of developing AKI after thoracic surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about thoracic surgery is to stay hydrated before and after the procedure to help prevent acute kidney injury. It is also important to follow all post-operative care instructions carefully to reduce the risk of complications. Additionally, maintaining a healthy lifestyle and managing any underlying medical conditions can also help improve outcomes after thoracic surgery.

Suitable For

Patients who are typically recommended for thoracic surgery include those with conditions such as lung cancer, esophageal cancer, benign tumors in the chest, severe lung infections, chest trauma, chronic obstructive pulmonary disease (COPD), and other lung diseases. These patients may require procedures such as lobectomy, pneumonectomy, esophagectomy, thoracotomy, or VATS (video-assisted thoracic surgery) to treat their condition.

It is important for healthcare providers to assess the individual patient’s risk factors for developing complications such as AKI following thoracic surgery. Factors such as older age, pre-existing kidney disease, diabetes, hypertension, heart failure, and use of certain medications can increase the risk of AKI.

Overall, thoracic surgery is a complex and invasive procedure that carries certain risks, including the potential for developing acute kidney injury. Healthcare providers should carefully evaluate each patient’s individual risk factors and take steps to prevent and manage AKI following thoracic surgery to optimize patient outcomes.

Timeline

Before thoracic surgery:

  • Consultation with a thoracic surgeon to discuss the procedure and potential risks
  • Pre-operative testing, including blood work, imaging studies, and possibly a cardiac evaluation
  • Patient education on what to expect during and after surgery
  • Anesthesia consultation to discuss the anesthesia plan for the surgery

After thoracic surgery:

  • Post-operative monitoring in the recovery area
  • Pain management to control discomfort after the surgery
  • Physical therapy to aid in recovery and prevent complications
  • Follow-up appointments with the surgeon to monitor healing and address any concerns
  • Rehabilitation to regain strength and function after the surgery

Overall, the timeline for a patient undergoing thoracic surgery involves pre-operative preparation, the surgery itself, and post-operative care to ensure a successful recovery. It is important for patients to closely follow their healthcare team’s instructions and attend all follow-up appointments to optimize their recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about thoracic surgery include:

  1. What are the potential risks and complications of thoracic surgery, including the risk of developing acute kidney injury?
  2. What measures will be taken to prevent or minimize the risk of acute kidney injury during and after surgery?
  3. How will my kidney function be monitored during and after the surgery?
  4. What are the signs and symptoms of acute kidney injury that I should watch out for after surgery?
  5. How will acute kidney injury affect my recovery and long-term health outcomes?
  6. Are there any pre-existing conditions or medications that may increase my risk of developing acute kidney injury after surgery?
  7. What is the hospital’s protocol for managing acute kidney injury if it occurs after thoracic surgery?
  8. Will I need any follow-up appointments or tests to monitor my kidney function after surgery?
  9. Are there any lifestyle changes or medications that can help reduce my risk of developing acute kidney injury in the future?
  10. Can you provide me with more information or resources about acute kidney injury and its implications for patients undergoing thoracic surgery?

Reference

Authors: Lei SH, Guo GF, Yan T, Zhao BC, Qiu SD, Liu KX. Journal: J Surg Res. 2023 Jul;287:72-81. doi: 10.1016/j.jss.2023.01.011. Epub 2023 Mar 2. PMID: 36870304