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Prevention of postoperative pneumonia after esophageal cancer surgery by topical antibiotics administration: A multicenter randomized control study

Research Project

Project/Area Number 17K17376
Research Category

Grant-in-Aid for Young Scientists (B)

Allocation TypeMulti-year Fund
Research Field Social dentistry
Research InstitutionNagasaki University

Principal Investigator

KAWAKITA Akiko  長崎大学, 医歯薬学総合研究科(歯学系), 助教 (10647241)

Project Period (FY) 2017-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Fiscal Year 2017: ¥1,950,000 (Direct Cost: ¥1,500,000、Indirect Cost: ¥450,000)
Keywords食道がん / 術後肺炎 / 抗菌薬局所投与 / 細菌数 / 多施設共同研究 / 食道癌肺炎予防 / 歯学
Outline of Final Research Achievements

Postoperative pneumonia occurred in 99 (12.8%) of 775 patients with thoracic esophageal cancer undergoing thoracoscopic surgery. The risk factors for development of pneumonia were old age, smoking habit, lower hemoglobin level, higher creatinine level, postoperative dysphagia, and lack of oral care.
The number of bacteria1 in the saliva was measured the day before and after surgery in esophageal cancer patients. The bacterial count did not increase after surgery in patients who took orally, whereas it significantly increased in those with fasting or intubation. Povidone iodine or tetracycline was administrated topically on the tongue in intubated patients, and the number of bacteria in the saliva was measured. As a result, topical tetracycline was the most effective in reducing the number of bacteria.

Academic Significance and Societal Importance of the Research Achievements

平成24年度に「周術期口腔機能管理」が診療報酬に新設された。食道がん手術は手術侵襲が大きく、嚥下機能障害や喀痰排出障害が高頻度で出現することなどから、術後肺炎のリスクが高いことが知られている。食道がん手術における周術期口腔機能管理の意義についてはいまだ不明確であり、実際に口腔内細菌の多寡と肺炎発症との関連性はあるのかどうか、抗菌薬局所投与により肺炎を抑制できるかなどについて明らかにすることが必要であると考えられた。
本研究の結果、抗菌薬局所投与は口腔内細菌数を減少させることが明らかとなり、肺炎予防に関与する可能性がある。

Report

(3 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • Research Products

    (1 results)

All 2017

All Journal Article (1 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 1 results,  Open Access: 1 results)

  • [Journal Article] Effect of perioperative oral care on prevention of postoperative pneumonia associated with esophageal cancer surgery2017

    • Author(s)
      Soutome Sakiko、Yanamoto Souichi、Funahara Madoka、Hasegawa Takumi、Komori Takahide、Yamada Shin-ichi、Kurita Hiroshi、Yamauchi Chika、Shibuya Yasuyuki、Kojima Yuka、Nakahara Hirokazu、Oho Takahiko、Umeda Masahiro
    • Journal Title

      madicine

      Volume: 96 Issue: 33 Pages: 7436-7436

    • DOI

      10.1097/md.0000000000007436

    • NAID

      120006373792

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Open Access / Int'l Joint Research

URL: 

Published: 2017-04-28   Modified: 2020-03-30  

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