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Utility of plasma D-dimer for diagnosis of venous thromboembolism after hepatectomy

World Journal of Clinical Cases 2024年第2期12卷 276-284页

作者： Taiichiro Miyake Hiroaki Yanagimoto Daisuke Tsugawa Masayuki Akita Riki Asakura Keisuke Arai toshihiko yoshida Shinichi So Jun Ishida Takeshi Urade Yoshihide Nanno Kenji Fukushima Hidetoshi Gon Shohei Komatsu Sadaki Asari Hirochika Toyama Masahiro Kido Tetsuo Ajiki Takumi Fukumoto Division of Hepato-Biliary-Pancreatic Surgery Department of SurgeryKobe University Graduate School of MedicineKobe 650-0017HyogoJapan

BACKGROUND Venous thromboembolism(VTE)is a potentially fatal complication of hepatectomy.The use of postoperative prophylactic anticoagulation in patients who have undergone hepatectomy is controversial because of the risk of postoperative bleeding.Therefore,we hypothesized that monitoring plasma D-dimer could be useful in the early diagnosis of VTE after hepatectomy.AIM To evaluate the utility of monitoring plasma D-dimer levels in the early diagnosis of VTE after hepatectomy.METHODS The medical records of patients who underwent hepatectomy at our institution between January 2017 and December 2020 were retrospectively analyzed.Patients were divided into two groups according to whether or not they developed VTE after hepatectomy,as diagnosed by contrast-enhanced computed tomography and/or ultrasonography of the lower extremities.Clinicopathological factors,including demographic data and perioperative D-dimer values,were compared between the two groups.Receiver operating characteristic curve analysis was performed to determine the D-dimer cutoff value.Univariate and multivariate analyses were performed using logistic regression analysis to identify significant predictors.RESULTS In total,234 patients who underwent hepatectomy were,of whom(5.6%)were diagnosed with VTE following hepatectomy.A comparison between the two groups showed significant differences in operative time(529 vs 403 min,P=0.0274)and blood loss(530 vs 138 mL,P=0.0067).The D-dimer levels on postoperative days(POD)1,3,5,7 were significantly higher in the VTE group than in the non-VTE group.In the multivariate analysis,intraoperative blood loss of>275 mL[odds ratio(OR)=5.32,95%confidence interval(CI):1.05-27.0,P=0.044]and plasma D-dimer levels on POD 5≥21μg/mL(OR=10.1,95%CI:2.04-50.1,P=0.0046)were independent risk factors for VTE after hepatectomy.CONCLUSION Monitoring of plasma D-dimer levels after hepatectomy is useful for early diagnosis of VTE and may avoid routine prophylactic anticoagulation in the postoperative period.

关键词： Hepatectomy Malignant tumor Postoperative complication D-dimer Early diagnosis Venous thromboembolism

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Evaluation of interfacial strength by an instrumented indentation method and its application to an actual TBC vane

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Acta Metallurgica Sinica(English Letters) 2011年第2期24卷 109-117页

作者： Yasuhiro YAMAZAKI Shin-ichiro KUGA toshihiko yoshida Department of Mechanical and Control Engineering Department of Advanced Production Systems Engineering Niigata Institute of Technology Graduate School Ryodensya Co.

The thermal fatigue behaviour of an air plasma sprayed thermal barrier coating was investigated. And also the interfacial strengths of thermal barrier coated specimens subjected to thermal fatigue, as well as a retired TBC vane were also evaluated by means of an instrumented indentation machine. The results indicated that, （1） the TGO grew at the interface during thermal fatigue cycle as a function of the exposure time at elevated temperature; （2） the microcracks were initiated in the top coating and at the interface after thermal cycle tests; （3） the interfacial strength of TBC, which was evaluated by the indentation method, increased with the thermal cycles; （4） the interfacial strength of the retired TBC vane was almost equal with that of the as-sprayed TBC specimen.

关键词： Thermal barrier coating Interfacial fracture toughness Indentation method

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Severe Mediastinal Emphysema and Tension Pneumothorax Caused by Cough-Induced Intercostal Lung Herniation

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Open Journal of Thoracic Surgery 2014年第1期4卷 1-4页

作者： Shinjiro Mizuguchi Masahide Kaji toshihiko yoshida Takeshi Iwasaki Takao Kamimori Hiroshi Fujiwara Department of Surgery National Hospital Organization Kobe Medical Center Kobe Japan Department of Surgery Yodogawa Christian Hospital Osaka Japan Respiratory Center Yodogawa Christian Hospital Osaka Japan

We report a case of cough-induced intercostal lung herniation with severe mediastinal emphysema and pneumothorax. A 60-year-old overweight man was admitted with dyspnea, chest pain, and chest wall bulging. Imaging confirmed left pneumothorax, fractures of the 8th to 10th ribs, and a defect in the 8th intercostal muscles. The presence of protrusion of lung parenchyma outside the intercostal space was unclear. Although the symptoms of tension pneumothorax disappeared after drainage, the subcutaneous emphysema was uncontrollable. Emergency surgery revealed lung injury near the 8th rib wedge not directly related to the rib fracture, and lung herniation was observed. We performed direct approximation of the ribs, and the lung parenchymal surface was encased by absorbable materials, avoiding infection risk. Although the lung herniation recurred 5 months later, the patient did not desire additional surgical repair. Non-absorbable materials should be considered for repair of lung herniation, excluding patients at high infection risk.

关键词： Intercostal Lung Herniation Cough/Sneeze Surgical Procedure

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Recent evidence for subcutaneous drains to prevent surgical site infections after abdominal surgery:A systematic review and metaanalysis

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World Journal of Gastrointestinal Surgery 2023年第12期15卷 2879-2889页

作者： Tomohiro Ishinuki Hiroji Shinkawa Keita Kouzu Seiichi Shinji Erika Goda Toshio Ohyanagi Masahiro Kobayashi Motomu Kobayashi Katsunori Suzuki Yuichi Kitagawa Chizuru Yamashita Yasuhiko Mohri Junzo Shimizu Motoi Uchino Seiji Haji Masahiro yoshida Hiroki Ohge toshihiko Mayumi Toru Mizuguchi Department of Nursing Surgical SciencesSapporo Medical UniversitySapporo 060-8556HokkaidoJapan Department of Hepatobiliary-Pancreatic Surgery Osaka Metropolitan University Graduate School of MedicineAbeno-Ku 545-0051Japan Department of Surgery National Defense Medical CollegeTokorozawa 359-8513Japan Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical SchoolTokyo 113-8602Japan Department of Nursing Japan Health Care UniversitySapporo 062-0053Japan Department of Liberal Arts and Sciences Center for Medical EducationSapporo Medical UniversitySapporo 060-8556Japan Department of Clinical Pharmacokinetics Research and Education Center for Clinical PharmacyKitasato UniversityTokyo 108-8641Japan Department of Anesthesiology Hokushinkai Megumino HospitalEniwa 061-1395Japan Department of Infectious Disease Medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan Department of Gastrointestinal Surgery National Center for Geriatrics and GerontologyObu 474-8511Japan Department of Anesthesiology and Critical Care Medicine Fujita Health UniversityToyoake 470-1192Japan Department of Gastrointestinal Surgery Mie Prefectural General Medical CenterYokkaich 510-8561Japan Department of Surgery Toyonaka Municipal HospitalToyonaka 560-8565Japan Department of Gastroenterological Surgery Hyogo Medical UniversityNishinomiya 663-8501Japan Department of Surgery Soseikai General HospitalKyoto 612-8473Japan Department of Hepato-Biliary-Pancreatic&Gastrointestinal Surgery International University of Health and WelfareIchikawa 272-0827Japan Department of Infectious Disease Hiroshima University HospitalHiroshima 734-8551Japan Department of Intensive Care Unit Chukyo HospitalJapan Community Health Care OrganizationNagoya 457-8510Japan

BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.

关键词： Abdominal surgery Mortality Seroma formation Subcutaneous drain Surgical site infections

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Recent Advanced neurosurgical procedure using integrated system of intraoperative MRI and neuronavigation with multimodal neuroradiological images

Recent Advanced neurosurgical procedure using integrated sys...

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中国抗癌协会神经肿瘤专业委员会第八届学术会议

作者： toshihiko Wakabayashi Masazumi Fujii Yasukazu Kajita Astushi Natsume Satoshi Maezawa Jun yoshida Department of Neurosurgery Nagoya University Graduate School of Medicine

＜正＞Recent promotion of collaboration between medical science and engineering brings significant advancement in the development of image diagnostic technology and surgical assist system. Using high-resolution micros...

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Laparoscopic Gastrectomy with Preservation of the Vagus Nerve Accompanied by Lymph Node Dissection for Early Gastric Carcinoma

Laparoscopic Gastrectomy with Preservation of the Vagus Nerv...

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胃癌诊治进展学习班

作者： Ichiro Uyama Yoichi Sakurai Yoshiyuki Komori Yasuko Nakamura Mitsutaka Syoji Syuhei Tonomura Ikuo yoshida toshihiko Masui Masahiro Ochiai Department of Surgery Fujita Health UniversitySchool of MedicineDengakugakuboKutsukake-choToyoakeAichiJapan MD Department of Surgery Fujita Health UniversitySchool of MedicineDengakugakuboKutsukake-choToyoakeAichiJapan MD FACS

Various types of function-preserving gastrectomy and limited gastrectomy have been performed in attempts to improve postoperative quality of life for early gastric carcinoma.Gastrectomy with preservation of the vagus nerve, which is one of the noteworthy procedures, is performed in Japan to reduce occurrence of cholelithiasis and minimize loss of digestive and absorptive function. Because it is less invasive, the laparoscopic approach is used to treat early gastric carcinomas.There are few reports in the English literature of laparoscopic

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