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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 | Extensive mesenteric venous thrombosis treatment by regional thmmbolysis显示文摘 | ESPEEL B GRARD C MANSVELT B | 2005 | Ann Fr Anesth Reanim2005，24，3： | 1 |
| 3 | Optical interaction between a dielectric tip and a nanometric lattice:implications for near field microscopy显示文摘 | Labani B Grard C Courjon D | 1990 | J Opt Soc A m B1990，7，6： | 1 |
| 4 | A 2 years follow up study of endovenous 980 nm laser treatment of the great saphenous vein: role of the blood content in the GSV显示文摘 | Desmyttere J Grard C Mordon S | 2005 | Medical laser application2005，20，4： | 1 |
| 5 | Music decreases sedative requirements during spinal anesthesia 显示文摘 | Lepage C Drolet P Grard M | 2001 | Anesth Analg2001，93，： | 1 |
| 6 | Zika virus in Gabon(Central Africa)-2007:a new threat from Aedes albopictus?显示文摘 | Grard G Mélanie C Illich Manfred M DieudonnéN Statiana MO Davy J Didier F Christophe P Eric Maurice L | 2014 | PLoS Negl Trop Dis2014，8，2： | 1 |
| 7 | Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up显示文摘 | Desmytt-re J Grard C Stalnikiewicz G | 2010 | Eur J Wasc Endovasc Surg2010，39，1： | 1 |
| 8 | Analytical and experimental investigations on thread milling forces in titanium alloy 显示文摘 | ANNA C A GUILLAUME F GRARD P | 2013 | International Journal of Machine Tools & Manufacture2013，，67： | 1 |
| 9 | Endovenous 980 -nm laser treatment of saphenous veins in a series of 500 patients显示文摘 | DESMYTTER E J GRARD C WASSMER B | 2007 | J Vasc Surg2007，46，6： | 1 |
| 10 | Evolutionary algorithm for stochastic arc routing problems显示文摘 | Grard F Lacomme P Prins C | 2004 | Applications of Evolu- tionary Computing2004，3005，： | 1 |
| 11 | MRI stuty of brain myelination显示文摘 | Grard Raybaud C | 1991 | J Neuroradiol1991，18，： | 1 |
| 12 | Analysis of sulfobutyl ether-beta-cyclodextrin mixtures by ion-spray mass spectrometry and liquid chromatography-ion-spray mass spectrometry显示文摘 | Grard S Elfakir C Dreux M | 2001 | J Chromatogr A2001，925，12： | 1 |
| 13 | Sulfobutyl ether-β-cyclodextrin fingerprint using ion pair reversed-phase chromatography显示文摘 | Grard S Elfakir C Dreux M | 1999 | Chromatographia1999，50，1112： | 1 |
| 14 | Characterization of sulfobutyl ether-β-cyclodextrins mixtures by anion-exchange chromatography using evaporative light scattering detection显示文摘 | Grard S Elfakir C Dreux M | 2000 | J Chromatogr A2000，897，12： | 1 |
| 15 | Endovenous laser ablation (980 nm) of the small saphenous vein in a series of 147 limbs with a 3-year follow-up显示文摘 | Desmyttare J Grard C Stalnikiewiez G | 2010 | Eur J Vase Endovasc Surg2010，39，1： | 1 |
| 16 | Endovenous 980 nm laser treatment of saphenous veins in a series of 500 patients 显示文摘 | Desmyttere J Grard C Wassmer B | 2007 | J Vasc Surg2007，46，6： | 1 |
| 17 | Heat-induced gelation of porcine blood plasma proteins as affected by p H显示文摘 | EDUARD D DOLOTS P GRARD C | 2007 | Meat Science2007，76，2： | 1 |
| 18 | Recovering the size of nanop- articles by digital in-line holography显示文摘 | Darawan P Sfibastien C Grard G Marc B Denis L Anis C Thomas G Dominique B | 2015 | Optics Express2015，23，18： | 1 |
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