Noritake Iwai

Clinical evaluation of long-term srvival after total gastrectomy

Twenty-seven cases of long-term survival after total gastrectomy were clinically evaluated. From the standpoint of general nutrition and rehabilitation, the patients appeared to be in satisfactory condition. However, hyperchromic anemia, serum vitamin B12 deficiency, and osteoporosis were noted in some patients.

Pulmonary function before and after abdominal surgery in the aged

AbstractIn patients 70 years or older, pulmonary function tests were performed before and after abdominal surgery to correlated the results with the development of postoperative pulmonary complications which developed in 48% of these patients, compared to 15% in the control group. To predict the development of PPC, preoperative analysis of the flow-volume curve is useful and

PULMONALY FUNCTIONS, BEFORE AND AFTER ABDOMINAL SURGERY OF AGED PATIENTS

4\left( {\dot V_{50} - \dot V_{25} } \right)/forced

A CASE OF JEJUNUM-INCARCERATED HIATUS HERNIA OF THE ESOPHAGUS ASSOCIATED WITH OMENTAL HIATUS HERNIA

vital capacity is a valuable parameter for the analysis of the flow-volume curve. Postoperatively, pulmonary function was reduced and there was a delay in the restoration of pulmonary function in cases with postoperative pulmonary complications. The administration of appropriate analgesics may be useful to improve postoperative ventilatory disturbances.

A CASE OF MALIGNANT MUCOCELE OF THE APPENDIX CAUSING INTUSSUSCEPTION CONCOMITANT WITH AN ASCENDING COLON CANCER

虫垂の粘液嚢胞腺癌より発症した腹膜偽粘液腫に対して, 原発巣切除に引き続きその再発予防を目的として, 持続温熱腹膜灌流療法 (continuous hyperthermic peritoneal perfusion: CHPP) を施行し, 良好な成績を得たので報告する. 症例は74歳の男性で, 下腹部膨満感を主訴に受診した. 虫垂粘液嚢胞腺癌を原発とする腹膜偽粘液腫で, 手術にて原発巣の切除と腹腔内のゼラチン様物質の除去を行った. 術後に, 45℃ に加温した生理食塩水10,000mlを左横隔膜下のドレーンよりイルリゲーターを用いて腹腔内に注入し, ダグラス窩および回盲部のドレーンより排出することにより灌流を行った. 1回の灌流時間は1時間とし, 術後数回CHPPを施行した. 術後5年以上ゼラチン様物質の再貯留を認めておらず, CHPPが腹膜偽粘液腫の再発予防に有効であると考えられた.

A CASE OF PLASMA CELL GRANULOMA OF THE STOMACH

70歳以上の高齢者の開腹手術前後に各種肺機能検査を施行し, 術後肺合併症との相関を検討した.高齢者の術後肺合併症の発生頻度は48%と高率であった.高齢者では, 術前より多彩な肺の病変を右し, とくに慢性閉塞性肺疾患を併存する例では, 術後肺合併症発生率が高く, かかる症例に対してはFlow-volume曲線は有用な検査法である.術後では, 早期の換気能障害は顕著であり, poor risk例および肺合併症合併例では術前値への回復が非常に遅延した.術後のhypoxemiaは無気肺に起因するshuntが主要因と思われる.