Abstract
The present study examined the effects of subtotal oesophagectomy through a right thoracal and abdominal approach, on the postoperative water-electrolyte metabolism and cardio-pulmonary function of patients with thoracic oesophageal carcinoma. The primary water balance, total sodium intake, urinary NAG index, free-water clearance (CH2O), oxygen diffusion function of the lungs to aerate blood (DLO 2-Index), and α-human atrial natriuretic polypeptide (α-hANP) were measured perioperatively until the seventh day. Subjects were divided by age according to whether they were older or younger than 70 years into 2 groups. In both groups, no change was observed in the primary water balance, total sodium intake, urinary NAG index or CH 2 O. However, all of the patients in the older group exhibited significantly higher α-hANP values than those in the control group, and the DLO 2-Index was also higher in the former subjects during the first 3 days following surgery. It may be concluded that α-hANP is a hormone of considerable importance as it is secreted in large amounts in response to increased stress on the cardio-pulmonary system and serves to normalize the water balance causing this extra load.
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This work was supported in part by a Grant-in-Aid (62770947) for Scientific Research of the Ministry of Education, Science and Culture of Japan
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Kojima, Y., Hiramatsu, Y., Nakagawa, A. et al. A comparative study of groups by age for the intra- and postoperative water and electrolyte management of oesophageal carcinoma. The Japanese Journal of Surgery 20, 515–525 (1990). https://doi.org/10.1007/BF02471007
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DOI: https://doi.org/10.1007/BF02471007