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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 | A new pelvic muscle trainer for the treatment of urinary incontinence 显示文摘 | Schmidt AP Sanches PR Silva DP Jr | 2009 | Int J Gynaecol Obstet2009，105，3： | 1 |
| 3 | Effectiveness of ProTaper, D-RaCe, and Mtwo retreatment files with and without supplementary instruments in the removal of root canal filling material 显示文摘 | Marques da Silva B Baratto-Filho F Leonardi DP | 2012 | Int Endod J2012，45，10： | 1 |
| 4 | Pnpulation study of pmen- strual syndrome显示文摘 | Silva CM Gigante DP Carrel ML el al | 2006 | Rev Saade Pablica2006，40，1： | 1 |
| 5 | Prevalence of thyroid autoirnmune disease in patients with systemic lupus erythematosus 显示文摘 | Viggiano DP da Silva NA Montandon AC | 2008 | Arq Bras Endocrinol Metabo12008，52，3： | 1 |
| 6 | Cognitive P300 potential in subjects with diabetes mellitus 显示文摘 | Alvarenga Kole F Duarte JL Silva DP | 2005 | Rev Bras Otorrinolaringol ( Engl Ed)2005，71，2： | 1 |
| 7 | Simultaneous determination of aspartame,cyclamate,saccharin and acesulfame-K in soft drinks and tabletop sweetener formulations by capillary electrophoresis with capacitively coupled contactless conductivity detection显示文摘 | Bergamo AB Silva JAF Jesus DP | 2011 | Food Chem Nutr2011，124，4： | 1 |
| 8 | Cognitive P300 potential in subjects with Diabetes Mellitus显示文摘 | Alvarenga Kde F Duarte JL Silva DP | | 0，，02： | 1 |
| 9 | Analysis of transient otoacoustic emissions and brainstem evoked auditory potentials in neonates with hyperbilirubi- nemia 显示文摘 | Silva DP Martins RH | 2009 | Braz J Otorhinolaryngo12009，75，3： | 1 |
| 10 | A review of methods of low alcohol and alcohol-free beer production显示文摘 | BRANYIK T SILVA DP BASZCZYNSKI M | | 0，，108： | 1 |
| 11 | Analysis of transient otoacoustic emissions and brainstem evoked auditory potentials in neo-nates with hyperbilirubinemia显示文摘 | Silva DP Martins RH | 2009 | Braz J Otorhinolaryngol2009，75，3： | 1 |
| 12 | Analysis of transient otoacoustic emissions and brainstem evoked auditory potentials in neonates with hyperbilirubinemia显示文摘 | Silva DP Martins RH | 2009 | Braz J Otorhinolaryngol2009，75，3： | 1 |
| 13 | Analysis of transient otoacoustic emissions and brainstem evoked auditory potentials in neonates with hyperbilirubinemia 显示文摘 | Silva DP Martins RH | 2009 | Braz J Otorhinolaryngol2009，75，3： | 1 |
| 14 | Population study of premenstrual syndrome显示文摘 | Silva CM Gigante DP Carret ML | 2006 | Rev Saude Publica2006，40，1： | 1 |
| 15 | Assessment of levels of otoacoustic emission response in neonates with perinatal asphyxia显示文摘 | Ribeiro GE da Silva DP Montovani JC | 2014 | Rev Paul Pediatr2014，32，3： | 1 |
| 16 | Prevalence of thy- roid autoimmune disease in patients with systemic lupus erythema- tosus 显示文摘 | Viggiano DP Silva NA Montandon AC | 2008 | Arq Bras Endocrinol Metabol2008，52，： | 1 |
| 17 | Population study of premenstrual syndrome显示文摘 | Silva CM Gigante DP Carret ML | 2006 | Rev Saude Pu-blica2006，40，1： | 1 |
| 18 | Strain-specific neutralizing determinant in the transmembrane protein of simian immunodeficiency virus显示文摘 | Kodama T Burns DP Silva DP | 1991 | J Virol1991，65，4： | 1 |
| 19 | Population study of pre- menstrual syndrome显示文摘 | Silva CM Gigante DP Carret ML | 2006 | Rev Saude Publiea2006，40，1： | 1 |
| 20 | Effect of agitation and aeration on production of hexokinase by Saccharomyces cerevisiae显示文摘 | Silva DP Pessoa A Jr Roberto IC | 2001 | Applied Microbiology and Biotechnology2001，9193，1： | 1 |
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