Taikang Xianlin Drum Tower Hospital｜Uremia after Rectal Cancer Surgery: MDT Saves a 60‑Year‑Old‑Plus Patient

Recently, Taikang Xianlin Drum Tower Hospital Affiliated to Nanjing University Medical School successfully treated a patient suffering from uremia after rectal cancer surgery. With full collaboration led by Director Zhou Hetong from the Department of Urology, together with the Intensive Care Unit, Nephrology Department, Oncology Department and Anesthesia & Operation Center, the patient’s condition turned for the better and he was discharged smoothly.

The 63‑year‑old male was admitted urgently for oliguria and poor appetite. He had a prior history of rectal cancer surgery with a long‑term colostomy. Urological examinations showed recurrent and metastatic rectal cancer had invaded his ureters and bladder, resulting in bilateral hydronephrosis. Upon admission, the patient developed severe renal failure with serum creatinine far above normal levels. He also presented with hyperkalemia, hypertension, severe anemia, arrhythmia and intramuscular venous thrombosis in the lower limbs, putting him at imminent risk of cardiac arrest.

Faced with this complex clinical case, the Department of Urology immediately launched a Multi‑Disciplinary Team (MDT) consultation. After repeated deliberations, the team prioritized stabilizing the patient’s vital signs. Emergency hemodialysis was performed to correct electrolyte disturbance alongside enhanced nutritional support. Once his general condition improved, Director Zhou Hetong planned minimally‑invasive ureteral stent implantation, with percutaneous nephrostomy reserved as an alternative procedure, to relieve urinary obstruction and prevent further deterioration of kidney function.

During surgery, Director Zhou’s team successfully placed a ureteral stent on the patient’s left side. However, complete tumor‑caused blockage of the right ureter prevented stent passage. Responding rapidly to this emergency, the team adjusted the treatment strategy and performed urgent right‑sided percutaneous nephrostomy, establishing a new urinary drainage pathway. Post‑operatively, under the care of the nursing team led by Head Nurse Sun Qingshuang from the Department of Urology, the patient’s urine output gradually recovered, serum creatinine declined steadily and renal function improved.

The Department of Urology at Taikang Xianlin Drum Tower Hospital reminds cancer patients to seek prompt medical attention for symptoms such as anuria, lumbago and abnormal kidney function. Going forward, the hospital will continue to uphold the patient‑centered care philosophy. Leveraging hospital‑wide MDT frameworks, specialists will combine strengths and complement one another to deliver therapeutic hope for more critically‑ill patients.

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