- 著者
- Kosho Yamanouchi Sayaka Kuba Chika Sakimura Mitsuhisa Takatsuki Naomi Hayashida Susumu Eguchi
- 出版者
- Nagasaki University School of Medicine
- 雑誌
- Acta Medica Nagasakiensia (ISSN:00016055)
- 巻号頁・発行日
- vol.61, no.2, pp.67-70, 2017 (Released:2018-03-30)
- 参考文献数
- 16
Background: Recently, the placement of drains in thyroidectomy has been debated. In this study, we evaluated the efficacy and safety of no placement of drains in hemithyroidectomy. Methods: After obtaining approval from the Institutional Review Board, we started not placing drains during surgery in adult patients who underwent hemithyroidectomy with or without central neck lymph node dissection for benign thyroid nodules or well-differentiated thyroid cancer, with informed consent being obtained. We compared the clinical data of the patients without drain placement (n=19) to the historical data of consecutive patients with a suction drain (n=20). Results: The operative wound and amount and characteristics of the drainage fluid were monitored every 2 h after the operation until the following morning, in addition to monitoring the oxygen saturation and an electrocardiogram. The proportion of patients undergoing cervical lymph node dissection was identical between the groups. The drain was removed on Day 1 after surgery in 19 patients and on Day 2 after surgery in 1 patient. The patients without a drain showed a significantly shorter postoperative hospital stay than those with a drain (4.0 vs. 4.5 days, respectively, p=0.03). No patients in either group experienced postoperative bleeding or seroma or wound infection. Conclusion: The hemithyroidectomy patients without a drain were able to be discharged earlier than those with a drain and without any adverse events, provided they received close monitoring after surgery.
- 著者
- Yuta Nakamura Ichiro Horie Kengo Kanetaka Susumu Eguchi Seiko Nakamichi Ryoko Hongo Miwa Takashima Atsushi Kawakami Norio Abiru
- 出版者
- The Japan Endocrine Society
- 雑誌
- Endocrine Journal (ISSN:09188959)
- 巻号頁・発行日
- pp.EJ22-0224, (Released:2022-07-26)
The postoperative increase in glucagon-like peptide-1 (GLP-1) is the main factor to improve glucose metabolism following sleeve gastrectomy (SG) in obese patients with type 2 diabetes. We investigated whether the β-cell responsiveness to an injection of exogenous GLP-1 in the preoperative period could determine the postoperative glucose tolerance in 18 patients underwent SG. In the preoperative period, a regular oral glucose tolerance test (OGTT) and an exenatide-challenge during OGTT (Ex-OGTT) were performed to evaluate the β-cell function and its responsiveness to GLP-1. The postoperative glucose tolerance was evaluated by another regular OGTT performed at 3 months after SG. The significant decrease in glucose levels with enhanced secretions of insulin and GLP-1 was observed in OGTT at 3 months after SG. The area under the curve of glucose from 0 to 120 minutes (AUC glucose0–120 min) and the insulinogenic index (I.I.) in OGTT at 3 months post-SG were significantly improved compared to those in preoperative period, but comparable with those in Ex-OGTT. AUC glucose0–120 min and I.I. in OGTT at 3 months post-SG were significantly correlated with not only those in Ex-OGTT, but also those in the preoperative regular OGTT. Conversely, the correlations calculated by the Spearman’s ρ were stronger in the latter than the former. This exenatide-challenge protocol might be useful to estimate glucose tolerance and insulin secretion after SG, however, it may be insufficient to improve predictability of a patient who is likely to achieve a significant benefit on glucose metabolism from receiving SG.