Clinical and Studies on systemic dysfunctions following total thoracic esophageal.
| Project/Area Number |
61480301
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| Research Category |
Grant-in-Aid for General Scientific Research (B)
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| Allocation Type | Single-year Grants |
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| Research Field |
Thoracic surgery
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| Research Institution | Kurume University |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
大森 聖也 久留米大学, 医学部, 助手 (00177007)
植田 正信 久留米大学, 医学部, 助手 (10160178)
白水 玄山 久留米大学, 医学部, 助手 (10154379)
山名 秀明 久留米大学, 医学部, 講師 (30140669)
藤田 博正 久留米大学, 医学部, 講師 (90156878)
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| Project Period (FY) |
1986 – 1987
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| Project Status |
Completed (Fiscal Year 1987)
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| Budget Amount *help |
¥6,800,000 (Direct Cost: ¥6,800,000)
Fiscal Year 1987: ¥1,000,000 (Direct Cost: ¥1,000,000)
Fiscal Year 1986: ¥5,800,000 (Direct Cost: ¥5,800,000)
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| Keywords | Esophageal Cancer / Total thoracic esophagectomy / Cardio-respiratory function / Chemical mediators / 嚥下性肺炎 / 術後腸管運動障害 / 食道癌 / 手術侵襲 / 生体反応 / 体液性因子 |
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| Research Abstract |
1. Clinical Studies; 1) The major change in cardio-respiratory functions immediately after total thoracic esophagectomy for esophageal cancer, was hypovolemia. However the pulmonary arterial pressure was clearly raised up to abnormal levels with an increase in extra vascular lung water volume on the 2nd to 3rd postoperative day by a refilling of the body fluid from the 3rd space to systemic vasculars. On the other hand, chemical mediastors were also raised up markedly including the drastic elevation of the serum level of thromboxane B2 immediately after the surgery. 2) In the study of small intestinal movement after total thoracic esophagectomy, the normal digestive waves under the hungry duration was found on the 20th postoperative ady and it was about 10 days behind as compared with that after total gastrectomy. dysfunction seemed to be related to the high serum levels of motiline. 3) The most important cause of postoperative pneumonia following the esophageal replacement with gastric tube was a regurgitation of the duodenal juice which was verifyed by a dynamic RI scah and a continuous intralumional pH-monitoring. 2. Experimental Studies ; 1) Experimental studies were performed by using mongrel dogs. In the cardio-respiratory functions before and immediately after total thoracic esophagectomy, pulmonary resistance was raised more than 100%, lung compliance was decreased about 70%, and extra vascular lung water was increased about 80% with a marked elevation of pulmonary arterial pressure and wedged pressure as compared to the previous level. On the other hand, catecholamine, renin-angiotensin system, and other chemical mediators elevated markedly except 5-HT and serotonin. In addition to this, a special elevation was noted in serum thromboxane B2 value against to the low value of 6-keto PGFla.
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Report
(2 results)
Research Products
(5 results)
