Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2012
Randomized Controlled TrialEffect of stroke volume variability- guided intraoperative fluid restriction on gastrointestinal functional recovery.
To investigate the effect of stroke volume variability(SVV)-guided intraoperative fluid restriction on gastrointestinal functional recovery and postoperative outcome after gastrointestinal surgery. Forty ASA I-II patients undergoing elective gastrointestinal surgery were randomly divided into 2 groups (n=20 each):group A routine fluid administration and group B restricted fluid administration. SW value was maintained at 5-7 in group A and 11-13 in group B. ⋯ Urine output in group A was significant less than in group B (p<0.05). Stroke volume variation measured from Edwards Flotrac sensor and Edwards Vigileo monitor could be a security and sensitive parameter as an index of volume administration. In elective gastrointestinal surgery, volume resuscitation with a goal SVV of11-13 not only reduced intravenous fluid volume but also maintained the stable hemodynamic and tissue perfusion, enhanced gastrointestinal functional recovery and reduced the length of hospital stay
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Hepato Gastroenterol · Oct 2012
Randomized Controlled TrialThe beneficial effects of Kampo medicine Dai-ken-chu-to after hepatic resection: a prospective randomized control study.
After hepatic resection, delayed flatus and impaired bowel movement often cause problematic postoperative ileus. Kampo medicine, Dai-kenchu-to (DKT), is reported to have a various beneficial effects on bowel systems. The aim of this study was to prospectively evaluate effects of DKT after hepatic resection. ⋯ DKT suppressed inflammatory reaction, stimulated bowel movement and improved oral intake after hepatic resection, which may decrease serious morbidity after hepatic resection.
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Hepato Gastroenterol · Oct 2012
Randomized Controlled TrialFast track rehabilitation programme enhances functional recovery after laparoscopic colonic resection.
Fast track (IT) rehabilitation programmes have demonstrated advantages over traditional perioperative care after open colonic surgery; however. their contribution in recovery after laparoscopic colonic surgery is not clearly defined. This study was conducted to estimate the value of FT rehabilitation programme in laparoscopic colonic resections. ⋯ When applied after laparoscopic colonic surgery, FT rehabilitation programme is feasible, safe and may lead to accelerated functional recovery and reductions in postoperative hospital stay.
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Hepato Gastroenterol · Jun 2012
Randomized Controlled TrialTerlipressin in the treatment of late phase catecholamine-resistant septic shock.
Norepinephrine, but also dopamine and epinephrine are recommended as first line vasopressors in the treatment of septic shock. In some patients, septic shock deteriorates and becomes to be resistant to catecholamines. In this situation, addition of vasopressin or terlipressin can be advantageous. The aim of our pilot study was to evaluate the impact of terlipressin on open label norepinephrine requirements and mortality. ⋯ Continuous terlipressin infusion was not effective in reducing norepinephrine consumption or in the mortality of patients, if administered in late phase of catecholamine refractory septic shock.
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Hepato Gastroenterol · May 2010
Randomized Controlled TrialProspective randomized controlled study of short-term perioperative oral nutrition with branched chain amino acids in patients undergoing liver surgery.
Early prospective randomized clinical trials demonstrated that perioperative parenteral nutrition (PN) with branched chain amino acids (BCAA) is beneficial in cirrhotic patients with hepatocellular carcinoma who undergo hepatectomy. However, PN support is expensive and requires a long hospital stay. Moreover, PN support has not been evaluated in patients with a normal liver who undergo hepatectomy. It was studied the benefits of perioperative oral nutrition (ON) with BCAA in patients who underwent hepatectomy, including those with a non-hepatitis liver. ⋯ Short-term ON support with BCAA was associated with higher serum EPO levels than was a normal diet in patients with non-hepatitis who underwent curative hepatic resection. Higher EPO levels might be beneficial in protecting liver cells from ischemic injury and preventing intraoperative hemorrhage associated with lower perioperative levels of alanine aminotransferase and aspartate aminotransferase in serum. This is the first study to demonstrate an effect of EN support with BCAA in patients with non-hepatitis, as well as those with hepatitis.