Toshiko Kamata, Shigetoshi Yoshida, Yuji Tada, Tetsuo Sato
{"title":"肺切除术后胃食管反流发生率的试点研究。","authors":"Toshiko Kamata, Shigetoshi Yoshida, Yuji Tada, Tetsuo Sato","doi":"10.21037/jtd-23-1794","DOIUrl":null,"url":null,"abstract":"<p><p>Patients undergoing lung resection may be at risk of gastroesophageal reflux (GER) and silent aspiration following surgery. Defining high-risk patients may lead to prevention strategies for silent aspiration and subsequent exacerbation of underlying pulmonary disease. A pilot study of 50 patients was performed to investigate postoperative gastroesophageal reflux disease (GERD) symptoms and the pepsin concentration in saliva. Patients answered a questionnaire concerning GERD symptoms before lung surgery and at the time of discharge. Saliva samples were obtained before surgery, on the third postoperative day and at discharge. Pepsin concentration was measured with Peptest. The pepsin concentration in saliva following resection was significantly elevated on postoperative day 3, but it returned to the baseline level at discharge. Patients undergoing resection of four or more lung subsegments had a continuously elevated pepsin concentration in saliva on postoperative day 3 [mean difference 65.63 ng/mL, 95% confidence interval (CI): 9.130-122.1] and at discharge (mean difference 76.22 ng/mL, 95% CI: 19.72-132.7). Patients with a >10% reduction of forced expiration volume in one second also had a continuous elevated pepsin concentration from the 3rd postoperative day. Lung resection resulted in elevated pepsin concentration in the saliva, which persisted in patients who received resections equivalent to or more than right middle lobectomy in volume. Resection of large volumes of lung may lead to anatomical changes and changes in breathing patterns and result in GER.</p>","PeriodicalId":17542,"journal":{"name":"Journal of thoracic disease","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320289/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pilot study of incidence of gastroesophageal reflux after lung resection.\",\"authors\":\"Toshiko Kamata, Shigetoshi Yoshida, Yuji Tada, Tetsuo Sato\",\"doi\":\"10.21037/jtd-23-1794\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Patients undergoing lung resection may be at risk of gastroesophageal reflux (GER) and silent aspiration following surgery. Defining high-risk patients may lead to prevention strategies for silent aspiration and subsequent exacerbation of underlying pulmonary disease. A pilot study of 50 patients was performed to investigate postoperative gastroesophageal reflux disease (GERD) symptoms and the pepsin concentration in saliva. Patients answered a questionnaire concerning GERD symptoms before lung surgery and at the time of discharge. Saliva samples were obtained before surgery, on the third postoperative day and at discharge. Pepsin concentration was measured with Peptest. The pepsin concentration in saliva following resection was significantly elevated on postoperative day 3, but it returned to the baseline level at discharge. Patients undergoing resection of four or more lung subsegments had a continuously elevated pepsin concentration in saliva on postoperative day 3 [mean difference 65.63 ng/mL, 95% confidence interval (CI): 9.130-122.1] and at discharge (mean difference 76.22 ng/mL, 95% CI: 19.72-132.7). Patients with a >10% reduction of forced expiration volume in one second also had a continuous elevated pepsin concentration from the 3rd postoperative day. Lung resection resulted in elevated pepsin concentration in the saliva, which persisted in patients who received resections equivalent to or more than right middle lobectomy in volume. Resection of large volumes of lung may lead to anatomical changes and changes in breathing patterns and result in GER.</p>\",\"PeriodicalId\":17542,\"journal\":{\"name\":\"Journal of thoracic disease\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-07-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11320289/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of thoracic disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.21037/jtd-23-1794\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/15 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of thoracic disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jtd-23-1794","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/15 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Pilot study of incidence of gastroesophageal reflux after lung resection.
Patients undergoing lung resection may be at risk of gastroesophageal reflux (GER) and silent aspiration following surgery. Defining high-risk patients may lead to prevention strategies for silent aspiration and subsequent exacerbation of underlying pulmonary disease. A pilot study of 50 patients was performed to investigate postoperative gastroesophageal reflux disease (GERD) symptoms and the pepsin concentration in saliva. Patients answered a questionnaire concerning GERD symptoms before lung surgery and at the time of discharge. Saliva samples were obtained before surgery, on the third postoperative day and at discharge. Pepsin concentration was measured with Peptest. The pepsin concentration in saliva following resection was significantly elevated on postoperative day 3, but it returned to the baseline level at discharge. Patients undergoing resection of four or more lung subsegments had a continuously elevated pepsin concentration in saliva on postoperative day 3 [mean difference 65.63 ng/mL, 95% confidence interval (CI): 9.130-122.1] and at discharge (mean difference 76.22 ng/mL, 95% CI: 19.72-132.7). Patients with a >10% reduction of forced expiration volume in one second also had a continuous elevated pepsin concentration from the 3rd postoperative day. Lung resection resulted in elevated pepsin concentration in the saliva, which persisted in patients who received resections equivalent to or more than right middle lobectomy in volume. Resection of large volumes of lung may lead to anatomical changes and changes in breathing patterns and result in GER.
期刊介绍:
The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.