Evaluation of the Associations between Gastric Tube Preparation Methods and the Incidence of Cervical Anastomotic Leakage after Esophagectomy for Thoracic Esophageal Cancer

2019 ◽  
Vol 37 (2) ◽  
pp. 154-162 ◽  
Author(s):  
Yutaka Miyawaki ◽  
Hiroshi Sato ◽  
Naoto Fujiwara ◽  
Hirofumi Sugita ◽  
Shinichi Sakuramoto ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Preparation Method ◽  
Multivariate Logistic Regression Analysis ◽  
Esophageal Reconstruction ◽  
Thoracic Esophageal Cancer ◽  
Preparation Methods ◽  
Brinkman Index ◽  
Flow Failure ◽  
Independent Risk Factors

Background: A gastric tube (GT) is most often selected as a reconstruction conduit in esophageal reconstruction. Although some leakage from esophagogastric anastomoses is induced by blood flow failure in reconstruction conduits, the association between the GT and the anastomotic leakage (AL) is unclear. Objectives: We retrospectively evaluated the incidence of AL according to the GT shape. Methods: Between February 2013 and September 2017, 188 consecutive patients who underwent esophagectomy with GT reconstruction were enrolled in this cohort study. We performed GT reconstruction using a narrow GT (Gr.N) until May 2016. Subsequently, we began preparing and using a stretched GT (Gr.S). Results: AL occurred in 29 of 188 (15.4%) patients. The frequency of AL was lower with Gr.S than with Gr.N (p = 0.034). Sex, body mass index, Brinkman index, hypertension, and anemia were significantly associated with AL (p = 0.033, 0.041, 0.003, 0.030, and 0.042, respectively). In a multivariate logistic regression analysis, the GT shape and the Brinkman index were shown to be independent risk factors for AL (p = 0.016 and 0.020, respectively). Conclusions: The GT preparation method is an independent risk factor for AL after cervical esophagogastrostomy. Thus, improved GT preparation methods could contribute to the reduction of AL after esophagectomy.

PS01.175: EVALUATION OF ASSOCIATIONS BETWEEN GASTRIC TUBE PREPARATION METHODS AND THE INCIDENCE OF CERVICAL ANASTOMOTIC LEAKAGE AFTER ESOPHAGECTOMY FOR THORACIC ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 99-99
Author(s):  
Yutaka Miyawaki ◽  
Hiroshi Sato ◽  
Sinich Sakuramoto ◽  
Koujun Okamoto ◽  
Shigeki Yamaguchi ◽  
...  
Keyword(s):  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Conflicts Of Interest ◽  
Multivariate Logistic Regression Analysis ◽  
Esophageal Reconstruction ◽  
Peripheral Blood Flow ◽  
Thoracic Esophageal Cancer ◽  
Preparation Methods ◽  
Brinkman Index ◽  
The Difference

Abstract Background In esophageal reconstruction, the gastric tube (GT) is superior in elevation and handiness of the maneuver; therefore, GT is most often selected as a reconstruction conduit. Although some leakages from esophagogastric anastomoses are induced by ischemic or congested peripheral blood flow in the reconstruction conduits, the association between the GT and the incidence of anastomotic leakage (AL) is unclear. Methods Between February 2013 and September 2017, 188 consecutive patients who underwent an esophagectomy with GT reconstruction were enrolled in this cohort study. We performed GT reconstructions using narrow gastric tubes (Gr.N) until May 2016, which is when we began preparing and using stretched GTs (Gr.S). We retrospectively evaluated the incidence of AL. Results AL occurred in 29 of 188 (15.4%) patients, and the frequency of AL occurrence in Gr.S was lower than that in Gr.N (P = 0.034). Sex, body mass index, Brinkman index, and presence of hypertension or anemia were significantly associated with AL (P = 0.033, 0.041, 0.003, 0.030, and 0.042, respectively). The multivariate logistic regression analysis suggested that the type of GT used and the Brinkman index were independent risk factors for AL (P = 0.016 and 0.020, respectively). Conclusion Our results demonstrated that the difference in the GT preparation method was an independent risk factor for AL after cervical esophagogastrostomy. We suggest that the method of GT preparation could contribute to a reduction of AL after esophagectomy. Disclosure All authors have declared no conflicts of interest.

PS01.132: RISK FACTORS OF ANASTOMOTIC LEAKAGE AFTER ESOPHAGECTOMY WITH GASTRIC TUBE RECONSTRUCTION FOR THORACIC ESOPHAGEAL CANCER

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 87-87
Author(s):  
Atsushi Sugimoto ◽  
Takahiro Toyokawa ◽  
Tatsuro Tamura ◽  
Katsunobu Sakurai ◽  
Naoshi Kubo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Gastric Tube ◽  
Prognostic Score ◽  
Univariate Analysis ◽  
Circular Stapler ◽  
Thoracic Esophageal Cancer ◽  
Independent Risk Factors ◽  
Mechanical Anastomosis

Abstract Background Anastomotic leakage is a major complication after esophagectomy. Recent studies reported that anastomotic leakage is associated with poor prognosis. We aimed to identify the risk factors of anastomotic leakage after esophagectomy for thoracic esophageal cancer. Methods We analyzed retrospectively consecutive patients who underwent esophagectomy with reconstruction using gastric tube by cervical anastomosis for thoracic esophageal cancer between January 2009 and December 2017. In the reconstruction, end-to side mechanical anastomosis with circular stapler through the posterior mediastinal route was preferred until 2014, and end-to end hand-sewn anastomosis through the retrosternal route was preferred from 2015. As inflammation-based and/or nutritional markers, prognostic nutritional index (PNI), modified Glasgow Prognostic Score (mGPS), Controlling Nutritional Status (CONUT) score, and neutrophil lymphocyte ratio (NLR) were investigated. Receiver operator characteristic curve analyses were performed to set the cut-off value of continuous variables. Risk factors predicting anastomotic leakage were analyzed using logistic regression model. Results A total of 170 patients (144 males and 26 females) were evaluated. Median age was 65 years (59 − 70). Anastomotic leakage was observed in 21 patients (12.3%). A mechanical anastomosis with circular stapler (P = 0.047) and longer operative time (≧560 minutes) (P = 0.015) were identified as risk factors of anastomotic leakage in univariate analysis. Multivariate analysis including variables with P < 0.1 on univariate analyses identified lower PNI (< 45) (P = 0.044, OR 2.78, 95% CI: 1.02 − 7.56) and mechanical anastomosis with a circular stapler (P = 0.036, OR 3.30, 95% CI: 1.07 − 10.09) as independent risk factors. Conclusion Our findings suggested that preoperative lower PNI and mechanical anastomosis were independent risk factors of anastomotic leakage after esophagectomy. Further studies aimed at preoperative nutritional intervention and anastomotic technique are warranted. Disclosure All authors have declared no conflicts of interest.

Scanning electron microscopy of human iliac bone by a simple preparation method

1990 ◽  
Vol 48 (3) ◽  
pp. 226-227
Author(s):  
Toshihiko Takita ◽  
Tomonori Naguro ◽  
Toshio Kameie ◽  
Akihiro Iino ◽  
Kichizo Yamamoto
Keyword(s):  
Electron Microscopy ◽  
Scanning Electron Microscopy ◽  
Preparation Method ◽  
Specimen Preparation ◽  
Real Surface ◽  
Public Attention ◽  
Preparation Methods ◽  
The Real ◽  
Simple Preparation ◽  
Scanning Electron

Recently with the increase in advanced age population, the osteoporosis becomes the object of public attention in the field of orthopedics. The surface topography of the bone by scanning electron microscopy (SEM) is one of the most useful means to study the bone metabolism, that is considered to make clear the mechanism of the osteoporosis. Until today many specimen preparation methods for SEM have been reported. They are roughly classified into two; the anorganic preparation and the simple preparation. The former is suitable for observing mineralization, but has the demerit that the real surface of the bone can not be observed and, moreover, the samples prepared by this method are extremely fragile especially in the case of osteoporosis. On the other hand, the latter has the merit that the real information of the bone surface can be obtained, though it is difficult to recognize the functional situation of the bone.

Epidemiological analysis of critically ill adult patients with pandemic influenza A(H1N1) in South Korea

2012 ◽  
Vol 141 (5) ◽  
pp. 1070-1079 ◽  
Author(s):  
S. B. HONG ◽  
E. Y. CHOI ◽  
S. H. KIM ◽  
G. Y. SUH ◽  
M. S. PARK ◽  
...  
Keyword(s):  
South Korea ◽  
Influenza A ◽  
Multivariate Logistic Regression Analysis ◽  
H1n1 Influenza ◽  
Epidemiological Analysis ◽  
Influenza A H1n1 ◽  
Failure Assessment ◽  
2009 H1n1 ◽  
Independent Risk Factors ◽  
Chronic Comorbidities

SUMMARYA total of 245 patients with confirmed 2009 H1N1 influenza were admitted to the intensive-care units of 28 hospitals (South Korea). Their mean age was 55·3 years with 68·6% aged >50 years, and 54·7% male. Nine were obese and three were pregnant. One or more comorbidities were present in 83·7%, and nosocomial acquisition occurred in 14·3%. In total, 107 (43·7%) patients received corticosteroids and 66·1% required mechanical ventilation. Eighty (32·7%) patients died within 30 days after onset of symptoms and 99 (40·4%) within 90 days. Multivariate logistic regression analysis showed that the clinician's decision to prescribe corticosteroids, older age, Sequential Organ Failure Assessment score and nosocomial bacterial pneumonia were independent risk factors for 90-day mortality. In contrast with Western countries, critical illness in Korea in relation to 2009 H1N1 was most common in older patients with chronic comorbidities; nosocomial acquisition occurred occasionally but disease in obese or pregnant patients was uncommon.

The Research on Preparation Methods of Sludge-Based Adsorbent and its Application in Water Treatment

2013 ◽  
Vol 798-799 ◽  
pp. 1166-1169 ◽  
Author(s):  
Kun Huang ◽  
Bing Xin Du
Keyword(s):  
Sustainable Development ◽  
Sewage Sludge ◽  
Preparation Method ◽  
Research Direction ◽  
Excess Sludge ◽  
Preparation Methods ◽  
Gas Treatment ◽  
Waste Gas ◽  
Waste Gas Treatment ◽  
Process Of Urbanization

The accelerated process of urbanization and industrialization leads to the increase of sewage sludge production. The reuse of excess sludge which meets the idea of sustainable development is aimed to develop it into resources. Preparation of sludge-based adsorbents with various functions provides a new way for sludge utilization as a resource in China. The preparation method of sludge-based adsorbents and its application in wastewater and waste gas treatment are introduced. Suggestions about the research direction of sludge-based adsorbents in the future are point out.

scholarly journals Effects of the preparation method on the structure and the visible-light photocatalytic activity of Ag2CrO4

2014 ◽  
Vol 5 ◽  
pp. 658-666 ◽  
Author(s):  
Difa Xu ◽  
Shaowen Cao ◽  
Jinfeng Zhang ◽  
Bei Cheng ◽  
Jiaguo Yu
Keyword(s):  
Photocatalytic Activity ◽  
Visible Light ◽  
Environmental Remediation ◽  
Preparation Method ◽  
Blue Shift ◽  
Preparation Methods ◽  
Visible Light Photocatalytic Activity ◽  
The Comparative Study ◽  
Hydrothermal Methods ◽  
Visible Light Photocatalytic

Silver chromate (Ag2CrO4) photocatalysts are prepared by microemulsion, precipitation, and hydrothermal methods, in order to investigate the effect of preparation methods on the structure and the visible-light photocatalytic activity. It is found that the photocatalytic activity of the prepared Ag2CrO4was highly dependent on the preparation methods. The sample prepared by microemulsion method exhibits the highest photocatalytic efficiency on the degradation of methylene blue (MB) under visible-light irradiation. The enhanced photocatalytic activity could be ascribed to the smaller particle size, higher surface area, relatively stronger light absorption, and blue-shift absorption edge, which result in the adsorption of more MB molecules, a shorter diffusion process of more photogenerated excitons, and a stronger oxidation ability of the photogenerated holes. Considering the universalities of microemulsion, precipitation, and hydrothermal methods, this work may also provide a prototype for the comparative study of semiconductor based photocatalysis for water purification and environmental remediation.

scholarly journals Risk Factors and Outcomes of Hospital Acquired Pneumonia in Young Bangladeshi Children

Life ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1030
Author(s):  
Abu Sadat Mohammad Sayeem Bin Shahid ◽  
Tahmina Alam ◽  
Lubaba Shahrin ◽  
K. M. Shahunja ◽  
Md. Tanveer Faruk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Severe Acute Malnutrition ◽  
Multivariate Logistic Regression Analysis ◽  
Acute Malnutrition ◽  
Persistent Diarrhea ◽  
Multivariate Logistic Regression ◽  
Resource Limited ◽  
Hospital Acquired Pneumonia ◽  
Independent Risk Factors ◽  
Hospital Acquired

Hospital acquired pneumonia (HAP) is common and often associated with high mortality in children aged five or less. We sought to evaluate the risk factors and outcome of HAP in such children. We compared demographic, clinical, and laboratory characteristics in children <5 years using a case control design during the period of August 2013 and December 2017, where children with HAP were constituted as cases (n = 281) and twice as many randomly selected children without HAP were constituted as controls (n = 562). HAP was defined as a child developing a new episode of pneumonia both clinically and radiologically after at least 48 h of hospitalization. A total of 4101 children were treated during the study period. The mortality was significantly higher among the cases than the controls (8% vs. 4%, p = 0.014). In multivariate logistic regression analysis, after adjusting for potential confounders, it was found that persistent diarrhea (95% CI = 1.32–5.79; p = 0.007), severe acute malnutrition (95% CI = 1.46–3.27; p < 0.001), bacteremia (95% CI = 1.16–3.49; p = 0.013), and prolonged hospitalization of >5 days (95% CI = 3.01–8.02; p < 0.001) were identified as independent risk factors for HAP. Early identification of these risk factors and their prompt management may help to reduce HAP-related fatal consequences, especially in resource limited settings.

scholarly journals Problems in Oral Intake after Esophageal Reconstruction with Gastric Tube and its Managements.

1995 ◽  
Vol 28 (10) ◽  
pp. 2072-2076
Author(s):  
Tatsuyuki Kawano ◽  
Kunihide Yoshino ◽  
Kagami Nagai ◽  
Haruhiro Inoue ◽  
Takeshi Nagahama ◽  
...  
Keyword(s):  
Gastric Tube ◽  
Oral Intake ◽  
Esophageal Reconstruction

scholarly journals Risk factors affecting the 1-year outcomes of minor ischemic stroke: results from Xi’an stroke registry study of China[1]

2020 ◽  
Author(s):  
Zhongzhong Liu ◽  
Wenjuan Lin ◽  
Qingli Lu ◽  
Jing Wang ◽  
Pei Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Ischemic Stroke ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Recurrence ◽  
Multivariate Logistic Regression ◽  
Factors Affecting ◽  
Nihss Score ◽  
Minor Ischemic Stroke ◽  
Independent Risk Factors

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.

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