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| 1 | Diagnostic value of drain amylase for detecting intrathoracic leakage after esophagectomy显示文摘AIM:To investigate the value of elevated drain amylase concentrations for detecting anastomotic leakage(AL) after minimally invasive Ivor-Lewis esophagectomy(MIILE).METHODS:This was a retrospective analysis of prospectively collected data in two hospitals in the Netherlands. Consecutive patients undergoing MI-ILE were included. A Jackson-Pratt drain next to the dorsal side of the anastomosis and bilateral chest drains were placed at the end of the thoracoscopic procedure. Amylase levels in drain fluid were determined in all patients during at least the first four postoperative days. Contrast computed tomography scans and/or endoscopic imaging were performed in cases of a clinically suspected AL. Anastomotic leakage was defined as any sign of leakage of the esophago-gastric anastomosis on endoscopy,re-operation,radiographic investigations,post mortal examination or when gastro-intestinal contents were found in drain fluid. Receiver operator characteristic curves were used to determine the cut-off values. Sensitivity,specificity,positive predictive value,negative predictive value,risk ratio and overall test accuracy were calculated for elevated drain amylase concentrations.RESULTS:A t o t a l o f 8 9 p a t ie n t s w e re in c lu d e d between March 2013 and August 2014. No differences in group characteristics were observed between patients with and without AL,except for age. Patients with AL were older than were patients without AL(P = 0.01). One patient(1.1%) without AL died within 30 d after surgery due to pneumonia and acute respiratory distress syndrome. Anastomotic leakage that required any intervention occurred in 15 patients(16.9%). Patients with proven anastomotic leakage had higher drain amylase levels than patients without anastomotic leakage [median 384 IU/L(IQR 34-6263) vs median 37 IU/L(IQR 26-66),P = 0.003]. Optimal cut-off values on postoperative days 1,2,and 3 were 350 IU/L,200 IU/L and 160 IU/L,respectively. An elevated amylase level was found in 9 of the 15 patients with AL. Five of these 9 patients had early elevations of their amylase levels,with a median of 2 d(IQR 2-5) before signs and symptoms occurred.CONCLUSION:Measurement of drain amylase levels is an inexpensive and easy tool that may be used to screen for anastomotic leakage soon after MI-ILE. However,clinical validation of this marker is necessary. | Gijs HK Berkelmans Ewout A Kouwenhoven Boudewijn JJ Smeets Teus J Weijs Luis C Silva Corten Marc J van Det Grard AP Nieuwenhuijzen Misha DP Luyer | 2015 | World Journal of Gastroenterology2015，21，30： | 3 |
| 2 | Partial matrix excision or orthonyxia for ingrowing toenails显示文摘 | Kruijff S van Det RJ van der Meer GT | 2008 | J Am Coll Surg2008，206，1： | 1 |
| 3 | Effects of the Diadromus pulchellus ascovirus,DpAV4 on the hemocytic encapsulation response and capsule melanization of the leek-moth pupa,Acrolepiopsis assectella显示文摘 | Renaut S Petit A Bénédet F Bigot S Bigot Y | 2002 | Journal of Insect Physiology2002，48，： | 1 |
| 4 | Neural reorganization accompanying upper limb motor rehabilitation from stroke with virtual reality-based gesture therapy显示文摘 | Orihuela-Espina F Fernandez det Casdllo 1 Palafox L | 2013 | Top Stroke Reha- bil2013，20，3： | 1 |
| 5 | Spinous process strength 显示文摘 | ShePherd DET Leahy JC Mathias KJ | 2000 | Spine2000，25，3： | 1 |
| 6 | Direct recoil radon emanation from crys- talline phases: Influence of moisture content显示文摘 | BARILLON R OZGUMUS A CHAMBAU- DET A | 2005 | Geochimica et Cosmochimica Aeta2005，69，11： | 1 |
| 7 | Synchronous tumours of the unilateral parotid gland: rare or undetected?显示文摘 | Clark J Zeebregts Walter J.B Mastboom Gerard van Noort Rob J.van Det | 2002 | Journal of Cranio-Maxillofacial Surgery2002，，1： | 1 |
| 8 | Theregulation of mitochondrial morphology : intricate mecha-nisms and dynamic machinery显示文摘 | Palmer C S Osellame L D Stojanovski Det | 2011 | Cell Signal2011，23，10： | 1 |
| 9 | Minimizing errors dur- ~ng in vitro testing of multisegmental spine specimens: consider- ations for component selection and kinematic measurement显示文摘 | G~det P Thistlethwaite PA Ferguson SJ | 2007 | J Biomech2007，40，8： | 1 |
| 10 | The amor phous oxides MnV2 O6+δ (0<δ<1) as high capacity neg ative electrode materials for lithium batteries显示文摘 | Piffard Y Leroux F Guyomard Det | 1997 | Jour nal of Power Sources1997，68，2： | 1 |
| 11 | Genetic features of resident biofilms determine attach ment of Listeria monocytogenes 显示文摘 | Habimana O Meyrand M Meylheuc T Kulakauskas S Brian det R | 2009 | Appl Environ Microhiol2009，75，： | 1 |
| 12 | Regulation of glomerular epithelial cell production of fibronectin and transforming growth factor-beta by high glucose,not by angiotensin Ⅱ显示文摘 | Van Det N Verhagen NA Tamsma JT | 1997 | Diabetes1997，46，5： | 1 |
| 13 | Comparative biomechanical investigation of a modular dynamic lumbar stabilization system and the Dynesys system显示文摘 | Gédet P Haschtmann D Thistlethwaite PA | | 0，，10： | 1 |
| 14 | Optimal experimental designs for inverse quadratic regression models 显示文摘 | DET'FE H KISS C | 2007 | Statistica Sinica2007，17，： | 1 |
| 15 | Spinous process strength显示文摘 | Shepherd DET Leahy JC Mathias KJ | | 0，，： | 1 |
| 16 | The diagnosis the exercise electrocardiogram:a meta and lysis of 22 years years of research显示文摘 | Det rano R Frodlicher V | 2011 | Prog Cardiovasc Dis2011，32，： | 1 |
| 17 | The ’instantaneous’ compressive modulus of human articular cartilage in joints of the lower limb显示文摘 | DET Shepherd BB Seedhom | 1999 | Rheumatology1999，，： | 1 |
| 18 | Mass spect romet ry- based metabolomics 显示文摘 | Det truer K Aronov PA Hammock BD | 2007 | Mass Spect romet ry Reviews2007，26，1： | 1 |
| 19 | Acute fractures of the scaphoid显示文摘 | | 2000 | J Am Acad Orthop Surg2000，8，4： | 1 |
| 20 | Spinous process strength显示文摘 | Shepherd DET Leahy JC Mathias KJ | 2000 | Spine2000，25，： | 1 |
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