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1998 Fiscal Year Final Research Report Summary

Changes in the perioperative management of hepatectomy and a nursing plan designed to improve the quality of life.

Research Project

Project/Area Number 09672389
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Nursing
Research InstitutionMie University

Principal Investigator

AKASHI Keiko  Mie University, Faculty of Medicine, Asociate Professor, 医学部, 助教授 (20231805)

Project Period (FY) 1997 – 1998
Keywordshepatectomy / perioperative management / complication / thoracoabdominal approach / autologous transfusions
Research Abstract

[Purpose] In order to draw up a nursing plan designed to improve the quality of life (QOL) of hepatectomy patients, we retrospectively investigated the hepatectomy patients 10 years ago and recently, and assessed changes from the standpoint of perioperative management and related factors.
[ Methods] Subjects : Group A consisted of 96 hepatectomy patients operated on 10 years previously(1985-1988), and Group B consisted of 109 hepatectomy patients operated on recently (1995-1998).Parameters : 1) Patient background ; underlying disease, preoperative condition, etc. 2) Surgical factors ; extent of hepatectomy, blood loss, whether a drain was used, etc. 3) Perioperative management ; percutaneous transhepatic biliary drainage (PTBD) and autologous bile ingestion, preoperative percutaneoustranshepatic portal vein embolization (PTPE), blood transfusions, start of postoperative oral feeding andambulation, etc. 4) Surgical results ; hospital deaths, postoperative complications.
[Results] 1) There … More were no differences between the two groups in patient background or extent of hepatectomy. In Group B, however, preoperative autologous bile ingestion and PTPE were performed, and the thoracoabdominal approach, microwave coagulation therapy, autologous transfusion were used, and in Group B it was possible to shorten postoperative drainage time, and start oral feeding and ambulation earlier. 2.) In Group B, hospital deaths and postoperative complications decreased, but the results in the patients with preoperative obstructive jaundice could hardly be described as satisfactory.
Conclusion] It has been possible to reduce postoperative complications and operative deaths in recent hepatectomy patients, compared with 10 years previously. The factors responsible for these changes seem to have been : (1) reduced surgical invasiveness as a result of preoperative PTPE, the thoracoabdominal approach, reduced blood loss, autologous transfusions, and (2) the advances and innovations inperioperative management, including minimal insertion and early withdrawal of catheters and drains. However, perioperative management of hepatectomy in cases associated with preoperative obstructive jaundice has sometimes been problematic, and that will be a future task. Less

  • Research Products

    (6 results)

All Other

All Publications (6 results)

  • [Publications] 飯田 俊雄: "体位変換と離床" 消化器外科. 20・4. 462-468 (1997)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] B.C.Das: "Nurtritional management-Do branched-chain amino acids improse the early postoperative course after hepatectomy?" 日本静脈・経腸栄養研究会誌. 13. 274-277 (1998)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] 明石 恵子: "消化器手術後のストレスに対する補中益気渇(TJ-41)の効果" PROGRESS IN MEDICINE. (印刷中). (1999)

    • Description
      「研究成果報告書概要(和文)」より
  • [Publications] Toshio IIDA: "Postural changes and ambulation" Gastroenterological Surgery. (in Japanese) 20 (4). 462-468 (1997)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] B.C.DAS: "Nurtritional management-Do branched-chain amino acids improve the early postoperative course after hepatectomy?" The Journal of Japanese Society for Parenteral and Enteral Nutrition. 13. 274-277 (1998)

    • Description
      「研究成果報告書概要(欧文)」より
  • [Publications] Keiko AKASHI: "Efficacy of TJ-41 in the treatment of postoperative stress following gastrointestinal surgery" Progress in medicine. (in Japanese) (printing now).

    • Description
      「研究成果報告書概要(欧文)」より

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Published: 1999-12-08  

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