Biomedical subjects

Koichi Sato

Publications and source records attributed to Koichi Sato.

75 records · Page 5Linked to original sources

PubMedDate not supplied

Deterioration of body oxygen metabolism by vasodilator and/or vasoconstrictor administration during cardiopulmonary bypass.

During cardiopulmonary bypass (CPB), tissue perfusion injury occurs even if perfusion pressure is maintained. Although a vasodilator and a vasoconstrictor are clinically administered if bypass flow is maintained, they may restore perfusion pressure without improving tissue perfusion. We evaluated the influence of vasodilators and vasoconstrictors on the whole body during CPB. Fifty-six patients with valvular disease who received moderately hypothermic CPB without blood transfusion were divided into four groups, depending upon whether a vasodilator and/or a vasoconstrictor was administered, and postoperative data were compared. Bypass flow and aortic pressure were maintained at 2.4 l/min/m and 5090 mm Hg. Body weight, dilution, hematocrit level, CPB, and aortic clamp duration, blood temperature, bypass flow, perfusion pressure, base excess levels during CPB, cardiac index, arterial and mixed venous oxygen pressure, and alveolar-arterial oxygen distribution after CPB were comparable among the four groups. However, the time to extubation was significantly longer. Blood lactate levels, measured for patients returned to the ward, were significantly higher in the agent-administered groups than in the no-agent group, whereas blood lactate levels on extubation and blood creatinine levels on postoperative day 1 were comparable among the groups. Vasodilator and/or vasoconstrictor administration during CPB may deteriorate the body oxygen metabolism, which might imply tissue perfusion and worsen the complications induced by hypoperfusion during CPB.

Aged↗

PubMedDate not supplied

Quality of life after laparoscopic or open colonic resection for cancer.

BACKGROUND/AIMS: Although laparoscopic colectomy has been widely accepted, little is known about the subjective clinical results of this less invasive surgery. The aim of this study was to evaluate the quality of life of patients who had undergone laparoscopic or open colonic resection for cancer. METHODOLOGY: The study included 26 patients with laparoscopic colectomy and 87 with conventional open colectomy for cure of colon cancer. Body temperature, serum C-reactive protein and albumin levels, lymphocyte count, and weight loss during hospital stay were compared between the two groups. Quality of life was estimated by the 9-item questionnaire with scoring system of 1 (high), 2 (fair), and 3 (low). RESULTS: Laparoscopic colectomy was significantly different from open colectomy with regard to the body temperature (37.8 degrees C vs. 38.0 degrees C, p < 0.01) and C-reactive protein level (6.34 mg/dL vs. 11.15 mg/dL, p < 0.01) on postoperative day 1, albumin level (3.54 g/dL vs. 3.36 g/dL, p < 0.05) and lymphocyte count (1354/mm3 vs. 995/mm3, p < 0.01) on postoperative day 7, and weight loss on postoperative day 14 (3.95% vs. 5.45%, p < 0.01). Although all patients with laparoscopic colectomy were satisfied with their surgical results, total score of the quality-of-life questionnaire was not significantly different between the two groups (10.95 vs. 11.81). Both laparoscopic and open colonic resections were similarly accepted by the patients as a good operation that they would recommend to others (1.105 vs. 1.206). CONCLUSIONS: These results indicate that although laparoscopic colonic resection for cancer was less invasive than conventional open colectomy, both laparoscopic and open colonic resections were favorably accepted by the patients, and quality of life after operation was not significantly different between the two procedures.

Colectomy↗

PubMedDate not supplied

Surgical technique influences bowel function after low anterior resection and sigmoid colectomy.

BACKGROUND/AIMS: Since June 1996, we have changed surgical strategies to preserve the pelvic autonomic nerve and abandon high ligation of the inferior mesenteric artery. The aim of this study was to clarify the influence of this surgical technique on subjective bowel function of patients with low anterior resection and sigmoid colectomy for cancer. METHODOLOGY: Forty-eight patients who underwent low anterior resection or sigmoid colectomy for cancer during June 1996 and February 2000 replied to the questionnaire which consisted of eight categories of bowel symptoms. Subjective bowel function and operative data of these patients were compared with those obtained from 84 patients with low anterior resection or sigmoid colectomy during April 1984 and May 1996. RESULTS: When recent series were compared with previous series, the frequency of bowel movement at night (21% vs. 60%, p < 0.01) and patient's own judgment as fair or poor (0% vs. 29%, p < 0.01) was decreased in patients with low anterior resection; whereas the frequency of defecation > 2 per day (5% vs. 34%, p < 0.01), difficulty in emptying (32% vs. 71%, p < 0.01), and incomplete evacuation (32% vs. 66%, p < 0.05) was decreased in patients with sigmoid colectomy. Patient judged as poor bowel function was less frequent in the recent group after low anterior resection (25% vs. 71%, p < 0.01) and sigmoid colectomy (18% vs. 42%, p < 0.05) compared with the previous group. Operative data including volume of blood loss, frequency of transfusion, and length of resected specimen were also different between the two groups. CONCLUSIONS: Surgical technique had a significant impact on bowel function following low anterior resection and sigmoid colectomy for cancer. When high ligation of the inferior mesenteric artery is abandoned and the pelvic autonomic nerve is preserved by careful technique, postoperative bowel dysfunction in patients with rectosigmoid colon cancer can be minimized.

Colectomy↗