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13. The role of geriatric nutritional risk index as a predictor for postoperative outcomes in gastrointestinal emergencies.

Author

Takano, Yasuhiro, Kobayashi, Yasunobu, Kudo, Tomohiro, Takahashi, Sumika, Kanno, Hironori, and Hanyu, Nobuyoshi

Subjects
GASTROINTESTINAL surgery, PREOPERATIVE risk factors, SURGICAL complications, OLDER people, TREATMENT effectiveness, SURGICAL emergencies
Abstract

Background: The geriatric nutritional risk index (GNRI) is a simple nutritional and inflammatory marker for older adults. The aim of the present study was to investigate the usefulness of the GNRI in older adults who underwent emergency gastrointestinal surgery. Methods: This study included 206 older adults who had undergone emergency gastrointestinal surgery. We retrospectively investigated the relationship between the GNRI and postoperative complications. Univariate and multivariate analyses were performed to evaluate risk factors for postoperative complications. We then evaluated the association between GNRI and clinical variables among older adults undergoing emergency gastrointestinal surgery. Results: Postoperatively, all complications occurred in 89 (43%) older adults, infectious in 53 (26%), and non‐infectious in 36 (17%). In the multivariate analysis, age (p = 0.016), GNRI (p = 0.012), operative severity (p = 0.003), and operation time (p = 0.003) were independent risk factors for all postoperative complications. While the GNRI (p = 0.049) was an independent risk factor for infectious complications, age (p = 0.035) and bleeding volume (p = 0.035) were independent risk factors for postoperative non‐infectious complications. In the low GNRI group, age (p = 0.029), serum C‐reactive protein levels (p < 0.001), and proportion of sarcopenia (p < 0.001) were significantly higher, and the length of hospital stay (p < 0.001) was significantly longer than that in the high GNRI group. In Spearman's rank correlation coefficient, the skeletal mass index and the GNRI had a positive correlation (r = 0.415 and p < 0.001). Conclusion: The GNRI may be a predictor of postoperative infectious complications in older adults after emergency gastrointestinal surgery, suggesting the usefulness of the GNRI as a nutritional marker and sarcopenia‐related parameter. Trial registration number: No. 22‐16. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Prognostic significance of osteosarcopenia in older adults with colorectal cancer.

Author

Takano, Yasuhiro, Kodera, Keita, Tsukihara, Shu, Takahashi, Sumika, Kobayashi, Yasunobu, Koyama, Muneyuki, Kanno, Hironori, Ishiyama, Satoshi, Hanyu, Nobuyoshi, and Eto, Ken

Subjects
OLDER people, COLORECTAL cancer, CANCER patients, BONE densitometry, BONE density
Abstract

Aim: Osteopenia and sarcopenia, features of the aging process, are recognized as major health problems in an aging society. This study investigated the prognostic impact of osteosarcopenia, the coexistence of osteopenia and sarcopenia, in older adults undergoing curative resection for colorectal cancer. Methods: We retrospectively reviewed data of older adults aged 65–98 y who had undergone curative resection for colorectal cancer. Osteopenia was evaluated by bone mineral density measurement in the midvertebral core of the 11th thoracic vertebra on preoperative computed tomography images. Sarcopenia was evaluated by measuring the skeletal muscle cross‐sectional area at the third lumbar vertebra level. Osteosarcopenia was defined as the coexistence of osteopenia and sarcopenia. We explored the relationship of preoperative osteosarcopenia with the disease‐free and overall survival after curative resection. Results: Among the 325 patients included, those with osteosarcopenia had significantly lower overall survival rates than those with osteopenia or sarcopenia alone (P < 0.01). In the multivariate analysis, male sex (P = 0.045), C‐reactive protein‐to‐albumin ratio (P < 0.01), osteosarcopenia (P < 0.01), pathological T4 stage (P = 0.023), and pathological N1/N2 stage (P < 0.01) were independent predictors of disease‐free survival, while age (P < 0.01), male sex (P = 0.049), C‐reactive protein‐to‐albumin ratio (P < 0.01), osteosarcopenia (P < 0.01), pathological T4 stage (P = 0.036), pathological N1/N2 stage (P < 0.01), and carbohydrate antigen 19–9 (P = 0.041) were independent predictors of overall survival. Conclusion: Osteosarcopenia was a strong predictor of poor outcomes in older adults undergoing curative resection for colorectal cancer, suggesting an important role of osteosarcopenia in an aging society. [ABSTRACT FROM AUTHOR]

Published
2023
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25. Significance of osteopenia in elderly patients undergoing emergency gastrointestinal surgery.

Author

Takano, Yasuhiro, Tsukihara, Shu, Kai, Wataru, Ito, Daisuke, Kanno, Hironori, Son, Kyonsu, Hanyu, Nobuyoshi, and Eto, Ken

Subjects
GASTROINTESTINAL surgery, OLDER patients, SURGICAL emergencies, PREOPERATIVE risk factors, OSTEOPENIA, BONE density
Abstract

Aim: Frailty assessment in elderly patients is crucial to predict the postoperative course, considering that frailty is highly associated with postoperative complications and mortality. The aim of this study was to evaluate the value of osteopenia as a risk factor for severe postoperative complications in elderly patients who underwent emergency gastrointestinal surgery. Methods: This study comprised 103 elderly patients who underwent emergency gastrointestinal surgery. Osteopenia was diagnosed by measuring bone mineral density, which was calculated as the average pixel density in the midvertebral core at the 11th thoracic vertebra on the preoperative plain computed tomography image. We retrospectively investigated the relationship between preoperative osteopenia and severe postoperative complications (Clavien–Dindo classification ≥III). Univariate and multivariate analyses were performed to evaluate the risk factors for severe postoperative complications. Results: Twenty‐three patients (22.3%) developed severe postoperative complications. The optimal cutoff value of bone mineral density for severe postoperative complications was 119.5 Hounsfield unit (HU) and 39 patients (37.9%) were diagnosed with osteopenia. The univariate analysis revealed that the American Society of Anesthesiologists Physical Status of ≥3 (P =.0084), hemoglobin levels (P =.0026), albumin levels (P <.001), sarcopenia (P =.015), and osteopenia (P <.001) were significantly associated with severe postoperative complications. The multivariate analysis showed that osteopenia (P =.014) was an independent risk factor for severe postoperative complications. Conclusion: Osteopenia may be a risk factor for severe postoperative complications in elderly patients after emergency gastrointestinal surgery. [ABSTRACT FROM AUTHOR]

Published
2022
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29. Abstracts of selected papers presented at the 79th general meeting of the Japanese Society of Gastroenterology March 29–31, 1993, Kyoto, Japan

Author

Uehara, Akira, Namiki, Masayoshi, Yoneda, Masashi, Taché, Yvette, Suzuki, Hidekazu, Miura, Soichiro, Otaka, Michiro, Masamune, Osamu, Fukudo, Shin, Nomura, Taisuke, Abe, R., Shimosegawa, T., Nakamura, Keiya, Aoike, Akira, Yamaguchi, Hiroya, Kimura, Toshinari, Nakamura, Toshikazu, Matsumoto, Kunio, Tomiya, Tomoaki, Fujiwara, Kenji, Mori, Kenji, Yasunaga, Mitsuru, Yasuda, Hiroshi, Kojima, Itaru, Ohnishi, Hiroo, Nagaki, Masahito, Koide, Norio, Tsuji, Takao, Nagano, Kouichi, Kawano, Sunao, Kihira, Ken, Satoh, Kiichi, Sakaki, Nobuhiro, Yamada, Yoshiya, Karita, Mikio, Yoshimatsu, Tateo, Nakashima, Takatoshi, Aoyama, Nobuo, Fukuda, Yoshihiro, Tamura, Kazutami, Sugiyama, T., Yabana, T., Lin, Jaw-Town, Sueoka, Nobuo, Iwakiri, Katsuhiko, Watanabe, Sumio, Sato, Nobuhiro, Yamasaki, Kazuaki, Okazaki, Kazuichi, Nishino, Hirokazu, Muroi, Tadaki, Matsuda, Yoshiro, Tsutsumi, Mikihiro, Oshita, Masahide, Takei, Yoshiyuki, Kumashiro, Ryukichi, Tanikawa, Kyuichi, Nagao, Yasuyuki, Okanoue, Takeshi, Tsukada, Nobuhiro, Oda, Masaya, Ishii, Motoyasu, Yamamoto, Takeshi, Komatsu, Masafumi, Nakajima, Ko, Sakisaka, Shotaro, Tanikawa, Kyuichi, Itoh, Fumio, Imai, Kohzoh, Shintani, Yutaka, Bamba, Tadao, Saito, Eiichi, Ogihara, Akifumi, Bamba, Tadao, Sasaki, Masaya, Fujimoto, Kazuma, Iwakiri, Ryuichi, Hosomi, Motonobu, Takada, Fumio, Obayashi, Makoto, Kitano, Atushi, Nagoshi, Sumiko, Fujiwara, Kenji, Tanaka, T., Monna, T., Matsuzaki, Yutaka, Sugimoto, Hiroyuki, Machishi, Hideki, Mizumoto, Ryuji, Matsuda, Kazuya, Uchida, Yoshihito, Okano, H., Aoyama, N., Yamada, Masahiko, Hongo, Michio, Shibata, Yoshihisa, Miyachi, Masahiko, Nimura, Yuji, Neya, Toshiaki, Mizutani, Masatoshi, Inoue, Jun, Nakamura, Masahiko, Aoyama, Nobuo, Futami, Sachiko, Funakoshi, K., Sugimura, K., Iwao, Yasushi, Hibi, Toshifumi, Kusugami, Kazuo, Morise, Kimitomo, Kimura, Mitsuo, Hiwatashi, Nobuo, Kanzaki, Shinichiro, Makiyama, Kazuya, Yamamura, Makoto, Satomi, Masamichi, Harada, Hirofumi, Shimada, Hiroshi, Yoshida, Norimasa, Yoshikawa, Toshikazu, Hiraishi, Hideyuki, Harada, Takashi, Suzuki, Masayuki, Miura, Soichiro, Masuda, E., Kawano, S., Matsui, H., Fukutomi, H., Oshitani, Nobuhide, Kitano, Atsuo, Suematsu, Makoto, Suzuki, Hidekazu, Togashi, Hitoshi, Shinzawa, Haruhide, Murakami, Hiroya, Takagi, Hiroshi, Kasugai, Hiroshi, Tatsuta, Masaharu, Urabe, Takeshi, Unoura, Masashi, Yamanaka, Naoki, Okamoto, Eizo, Takayama, Tadatoshi, Yamasaki, Susumu, Kita, Kazuhiko, Ebara, Masaaki, Majima, Yasuo, Tanikawa, Kyuichi, Matsui, Osamu, Demachi, Hiroshi, Seki, Toshihito, Inoue, Kyoichi, Ohnishi, Kunihiko, Ito, Susumu, Kaneko, Akira, Hayashi, Norio, Yoneyama, Keiichiro, Mitamura, Keiji, Higashi, Katsuyoshi, Hoshino, Makoto, Ogasawara, Hisataka, Sirahama, Keigo, Hashimoto, Naoki, Yamada, Haruki, Shiratori, Yasushi, Okano, Ken’ichi, Minemura, Masami, Watanabe, Akiharu, Masaki, Tsutomu, Tokuda, Masaaki, Kawano, Tatsuyuki, Endo, Mitsuo, Kouzu, Teruo, Sakaguchi, Humiaki, Hanyu, Nobuyoshi, Aoki, Teruaki, Shimamoto, Chikao, Hirata, Ichiro, Sasajima, Koji, Takubo, Kaiyo, Kawaura, Yukimitsu, Kawakami, Kazuyuki, Hayashi, Hiroto, Suzuki, Takashi, Watanabe, Kazuo, Watanabe, Hidenobu, Hino, Naoki, Higashi, Toshihiro, Shiro, Tomohiro, Inoue, Kyoichi, Hongo, Yasushi, Tada, Hideki, Saitoh, K., Akiyama, Y., Mitsufuji, Shoji, Tsuchihashi, Yasunari, Nishimura, K., Hosokawa, Y., Wada, Ryo, Suda, Kouichi, Mafune, Ken-ichi, Idezuki, Yasuo, Mizuno, Motowo, Tsuji, Takao, Watanabe, Mamoru, Hibi, Toshifumi, Matsumoto, Takayuki, Kobayashi, Kenzo, Morise, Kimitomo, Yamaguchi, Takeo, Watanabe, T., Kubota, Y., Andoh, Akira, Fujiyama, Yoshihide, Tanaka, Kanji, Hioki, Koshirou, Hinoda, Yuji, Imai, Kohzoh, and Ohtani, Haruo

Published
1993
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30. Abstracts of selected papers presented at the 78th general meeting of the Japanese Society of Gastroenterology

Author

Kusano, Motoyasu, Sekiguchi, Toshikazu, Hanyu, Nobuyoshi, Aoki, Teruaki, Matsushima, Yasuhiro, Okamoto, Eizo, Takeda, Yasuo, Takeda, Ryoyu, Miyachi, Masahiko, Nimura, Yuji, Arai, Taidoh, Masuda, Jun, Tanaka, Masao, Ogawa, Yoshiaki, Ura, Kazuhide, Matsumoto, Teiji, Taniyama, K., Kurosawa, Susumu, Owyang, Chung, Baba, Hiroshi, Fujimura, Masaki, Hamada, Eiji, Shimada, Tadahito, Kabemura, Teppei, Chijiiwa, Yoshiharu, Sato, T., Koito, K., Matsuda, Hiroko, Kawasaki, Tsunehisa, Obara, Katsutoshi, Kasukawa, Reiji, Miyoshi, Hirofumi, Matsumoto, Akio, Yamamoto, Manabu, Ohmasa, Ryouji, Kokubu, Shigehiro, Shibata, Hisao, Tajiri, Takashi, Onda, Masahiko, Hashizume, Makoto, Sugimachi, Keizo, Kobayashi, Kenji, Shiozaki, Hitoshi, Fujisaki, Junko, Shimoda, Tadakazu, Hase, Satoshi, Tsukamoto, Yoshihisa, Atsumi, M., Konishi, H., Nakajo, Shinobu, Fujiyama, Yoshihide, Taruishi, Masaki, Ayabe, Tokiyoshi, Morise, Kimitomo, Yamaguchi, Takeo, Makiyama, Kazuya, Itsuno, Minoru, Matsui, T., Okabe, N., Okabe, Nobuo, Matsui, Toshiyuki, Sakatani, Arata, Koizumi, Koichi, Imai, Yutaka, Sugino, Yoshinori, Masaki, Tadahiko, Sawada, Toshio, Nishigami, Takashi, Satomi, Masamichi, Hatada, Yasumasa, Saito, Hiroshi, Kobayshi, Kiyonori, Katsumata, Tomoe, Sugimoto, Kenji, Itabashi, Tsukasa, Kitagawa, Motoji, Hayakawa, Tetsuo, Okazaki, Kazuichi, Yamamoto, Yasuro, Funakoshi, Akihiro, Miyasaka, Kyoko, Soejima, Kazuhiko, Kanda, Mikio, Sugiyama, Masanori, Kuroda, Akira, Inoue, Hisayuki, Bamba, Tadao, Hamanaka, Y., Suzuki, T., Suzuki, Mamoru, Hanyu, Fujio, Tamura, Katsuhiro, Nakase, Akira, Noguchi, M., Hiwatashi, N., Murata, Yuhji, Suzuki, Kazuo, Ohtani, Haruo, Watanabe, Yoshihisa, Zeniya, Mikio, Aizawa, Yoshio, Masumoto, T., Onji, M., Hamasaki, Keisuke, Nakata, Keisuke, Fukui, Hiroshi, Tsujii, Tadasu, Yamashiki, Masayoshi, Nishimura, Akira, Tsutsui, Hiroko, Mizoguchi, Yasuhiro, Kimura, Fumio, Miyazaki, Masaru, Kiyota, Keisuke, Inokuchi, Hideto, Yamamoto, Yoshihiro, Oka, Hiroshi, Horikoshi, Tsutomu, Sekiguchi, Toshikazu, Takayasu, H., Shirai, T., Hongo, Michio, Okuno, Yo, Okano, H., Aoyama, N., Ohsuki, Masao, Maeda, Kenji, Haruma, Ken, Sumii, Koji, Nakai, Yoshihide, Fukunaga, Mikihiko, Kaneko, Hiroshi, Morise, Kimitomo, Okumura, Toshikatsu, Uehara, Akira, Fukuda, Yoshihiro, Satomi, Masamichi, Joh, Takashi, Itoh, Makoto, Kitagawa, Yuko, Kitajima, Masaki, Iwao, Tadashi, Toyonaga, Atsushi, Nakamura, Masahiko, Oda, Masaya, Kawamura, Yukimitsu, Dohden, Kenji, Kamiyama, Yasuhiko, Matsuno, Seiki, Hirano, Morihisa, Otsuka, Sachio, Ito, Masahiro, Sekine, Ichiro, Ogihara, Tatsuo, Sato, Nobuhiro, Uehara, Akira, Namiki, Masayoshi, Sugiura, Nobuyuki, Ebara, Masaaki, Matsuo, Naoki, Uchida, Hideo, Okada, Shuichi, Okazaki, Nobuo, Tsujii, Hirohiko, Ohsuga, Toshiaki, Abe, M., Nagata, Y., Yamasaki, Susumu, Kosuge, Tomoo, Kitamoto, Mikiya, Nakanishi, Toshio, Ichikawa, Yuzo, Mizoguchi, Yasuhiro, Ohtake, Yoshio, Hirasawa, Hiroyuki, Sugihara, Junichi, Muto, Yasutoshi, Yasunaga, Mitsuru, Okita, Kiwamu, Ukida, Minoru, Tsuji, Takao, Isai, Hideya, Uchino, Junichi, Suzuki, Katsuhiko, Komatsu, Kanji, Ohtomo, Yumiko, Idezuki, Yasuo, Sakuramachi, Shunji, Kimura, Taizo, Kitano, Seigo, Sugimachi, Keizo, Moriyama, Masaaki, Yazaki, Yasuyuki, and Saito, Takashige

Published
1993
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32. Abstracts of selected papers presented at the 77th General Meeting of the Japanese Society of Gastroenterology: March 28–30, 1991, Tokyo, Japan

Author

Kijima, Hiroshi, Watanabe, Hidenobu, Tomatsu, Sei, Oi, Itaru, Nagaiwa, Jiro, Ariyama, Jo, Mitake, Masahiro, Naitoh, Yasuo, Ono, Yoshiki, Yokomizo, Seiji, Nakayama, Toshimichi, Sugimura, Fumiaki, Matsuo, Yutaka, Murayama, Isao, Tanaka, Takashi, Hanyu, Nobuyoshi, Aoki, Teruaki, Shiraha, Sei, Shiraha, Sei, Hiura, Akihito, Satake, Katsusuke, Suda, Koichi, Sakamoto, Yoshiya, Okazaki, Kazuichi, Kondo, Takaharu, Hayakawa, Tetsuo, Kanoh, Makoto, Kohashi, Etsu, Kataoka, Keisho, Kashima, Kei, Yokotani, Kunihiko, Yamada, Tadataka, Mieno, Hiroshi, Shirakawa, Toshio, Komatsu, Hirokazu, Oda, Masaya, Nakamura, Keiya, Aoike, Akira, Takagi, Yoji, Inoue, Yoshifumi, Kasahara, Hiroshi, Saitoh, Yoichi, Tashiro, T., Mashima, Y., Sasaki, Fumiaki, Uchino, Junichi, Haraguchi, Yoshikura, Kirita, Manabu, Iwasa, Masato, Ogoshi, Shohei, Sato, Nobuaki, Matsubara, Youichi, Kinouchi, Y., Hiwatashi, N., Chikamochi, Nobuo, Nakajo, Shinobu, Yoshida, Takashi, Muto, Yasutoshi, Suzuki, Kazutomo, Arakawa, Yasuyuki, Takahashi, Hiroaki, Noguchi, Takashi, Suzuki, Hiroshi, Okabe, Kazuhiko, Azuma, Megumu, Koizumi, Masaru, Kawaguchi, Shinya, Matsuno, Seiki, Tsuji, Shingo, Kawano, Sunao, Oda, Masaya, Nakamura, Masahiko, Nakamura, Hajime, Kobayashi, Kenzo, Kashiwagi, Hideyuki, Aoki, Teruaki, Nishikawa, Masahiro, and Suzuki, Takashi

Published
1992
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35. Clinical outcomes of laparoscopic cholecystectomy with accidental gallbladder perforation.

Author

Usuba, Teruyuki, Nyumura, Yuya, Takano, Yuki, Iino, Toshio, and Hanyu, Nobuyoshi

Subjects
GALLBLADDER surgery, CHOLECYSTECTOMY, C-reactive protein, ANTI-infective agents, HEALTH outcome assessment
Abstract

Introduction Accidental gallbladder perforation frequently occurs during laparoscopic cholecystectomy and may increase the risk of infection. However, the necessity of antimicrobial prophylaxis for these patients is unclear. The aim of this study was to examine the clinical outcomes and necessity of antimicrobial prophylaxis after laparoscopic cholecystectomy with gallbladder perforation. Methods One hundred patients who underwent laparoscopic cholecystectomy were divided into two groups: patients with gallbladder perforation (Group A, n = 37) and patients without perforation (Group B, n = 63). We compared the white blood cell count and C-reactive protein level the day after the operation, the complication rates of systemic inflammatory response syndrome and surgical-site infection, and postoperative hospital stay between the two groups. All patients received antimicrobial prophylaxis only once before the operation. Results There were significant differences in every variable with the exception of postoperative hospital stay. Group A had a higher risk of infection, but the postoperative clinical course of Group A was not inferior to that of Group B. Conclusion The clinical outcomes of patients with accidental gallbladder perforation were acceptable, and the use of antimicrobial prophylaxis once before the operation was sufficient. [ABSTRACT FROM AUTHOR]

Published
2017
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36. Assessment of Motor Function of the Remnant Stomach by C Breath Test With Special Reference to Gastric Local Resection.

Author

Kawamura, Masahiko, Nakada, Koji, Konishi, Hideo, Iwasaki, Taizo, Murakami, Keishiro, Mitsumori, Norio, Hanyu, Nobuyoshi, Omura, Nobuo, and Yanaga, Katsuhiko

Subjects
MOTOR ability research, STOMACH, GASTRECTOMY, BREATH tests, GASTROINTESTINAL stromal tumors
Abstract

Background: Indications for gastric local resection (LR) include gastrointestinal stromal tumors, neuroendocrine tumors, and early gastric cancer. LR is expected to preserve physiological function and ameliorate postgastrectomy syndrome. Methods: Gastric emptying was assessed by the C-acetate breath test in 20 healthy volunteers (HVs) and 60 gastrectomized patients [distal gastrectomy with Billroth I reconstruction (DGBI) in 26 patients, LR in 34 patients]. For the C breath test, 100 mg of C-acetate sodium salt was mixed in a test meal. Breath samples were collected before intake and during the next 3 h. We compared the gastric reservoir capacity using the gastric retention rate at 5 min (RR5) and gastric emptying by the half emptying time (T½). Patients completed a questionnaire survey about their symptoms, dietary intake, body weight, and restriction of activities of daily living [reflecting quality of life (QOL)]. Results: The RR5 values for the HV, LR, and DGBI groups were 93.7, 90.0, and 45.3* %, respectively (*compared to HV and LR, p < 0.0001). The T½ values were 23.3, 20.2, and 5.9* min, respectively. Dietary intake and body weight change were significantly more reduced in the DGBI group than the LR group ( p < 0.05). Subgroup analysis indicated that the reservoir capacity in those with LR at the lesser curvature was more disturbed than that in patients with LR at the greater curvature. The questionnaire showed no differences in those patients' QOL. Conclusions: Because the reservoir capacity, the gastric emptying and QOL were maintained, LR is an option for selected patients with early gastric cancer. [ABSTRACT FROM AUTHOR]

Published
2014
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40. Relative displacement of anastomotic site of pancreato-jejunostomy in pancreatico-duodenectomy: a novel surgical reconstructive technique.

Author

Usuba, Teruyuki, Iino, Toshio, and Hanyu, Nobuyoshi

Subjects
PANCREATIC fistula, PANCREATICODUODENECTOMY, FIBRIN tissue adhesive, HEMORRHAGE prevention, PANCREATIC secretions
Abstract

Introduction: Intra-abdominal hemorrhage following pancreatic fistula is a fatal complication after pancreatico-duodenectomy. Intra-abdominal hemorrhage has reportedly decreased with the use of fibrin glue or polyglycolic acid felt and wrapping of the skeletonized vessels by omentum or falciform ligament. However, there are no extremely effective methods for the prevention of hemorrhage. Here, we report our novel and simple method for the prevention of intra-abdominal hemorrhage due to pancreatic fistula. Methods: The anastomotic site of the pancreato-jejunostomy in pancreatico-duodenectomy is displaced from the superior to inferior side of the transverse mesocolon through a small window created on the left side of the middle colic artery of the transverse mesocolon. This procedure is expected to prevent exposure of the skeletonized vessels to activated pancreatic juice from a pancreatic fistula after lymph node dissection, decreasing the incidence of hemorrhage. Two drains are placed on the superior and inferior sides of the transverse mesocolon. We performed this procedure in seven patients and compared the amylase level in the drainage fluid from the superior and inferior sides. Results: There was no difference in the fluid amylase level from the drains between the superior and inferior sides, because a pancreatic fistula was not present in all our patients. Therefore, we could not evaluate the efficacy of this method in the current study. Conclusions: Our procedure is theoretically expected to prevent intra-abdominal hemorrhage and will be an option in pancreatico-duodenectomy, especially for patients with a soft pancreas. However, it is necessary to evaluate the performance and results of this procedure in many more patients. [ABSTRACT FROM AUTHOR]

Published
2013
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44. Lactate Levels in the Detection of Preoperative Bowel Strangulation.

Author

Tanaka, Keiichiro, Hanyu, Nobuyoshi, Iida, Tomonori, Watanabe, Atsushi, Kawano, Susumu, Usuba, Teruyuki, Iino, Toshio, and Mizuno, Ryoji

Subjects
*LACTATES, *PREOPERATIVE care, *BOWEL obstructions, *BLOOD cell count, *CREATINE kinase
Abstract

The aim of this retrospective study was to examine whether various laboratory parameters could predict viability of strangulation in patients with bowel obstruction. Forty patients diagnosed with bowel strangulation were included. We performed operations for all patients within 72 hours of the start of symptoms. Blood samples were obtained from all patients immediately before operation. Arterial blood was examined for pH and lactate levels using a blood gas analyzer. We also evaluated white blood cell count and serum levels of creatine phosphokinase, lactic dehydrogenase, amylase, and C-reactive protein. At surgery, 18 patients had viable strangulation and did not undergo resection, whereas 22 had nonviable strangulation and underwent resection of the necrotic bowel. None of the patients died. Bowel strangulation was caused most commonly by adhesions. In terms of diagnostic efficiency, lactate level was the only laboratory parameter significantly associated with viability (P < 0.01, Mann-Whitney test). Other laboratory data did not show statistically significant associations. These results suggest that arterial blood lactate level (2.0 mmol/L or greater) is a useful predictor of nonviable bowel strangulation. [ABSTRACT FROM AUTHOR]

Published
2012
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