[The correlation between plasma atrial natriuretic polypeptide levels (ANP) and cardio-pulmonary function during the perioperative period of esophageal cancer].
The present study examined the influence of subtotal esophagectomy through r-thoracal and abdominal approach on plasma atrial natriuretic polypeptide (ANP) and postoperative cardiopulmonary function using the Swan-Ganz Catheter in patients with thoracic esophageal cancer. The cardiac output (CO), left ventricular stroke work index (LVSWI), pulmonary vascular resistance (PVR), systemic vascular resistance (SVR), and plasma atrial natriuretic polypeptide levels (ANP) were measured during the perioperative period till the 3rd day. Subjects were divided into 2 groups by preoperative PVR values, those over 100 dynes.sec.cm-5 (PVR group), and those less than 100 dynes.sec.cm-5 (N group). Significant correlations were observed between ANP and CO (r = -0.63, P = 0.028), PVR (r = 0.66, P = 0.018), LVSWI (r = -0.71, P = 0.0009) and SVR (r = 0.71, P = 0.009) at 3 hours after operation. And the correlations between ANP and CO (r = 0.54, P = 0.049), PVR (r = -0.69, P = 0.019) and LVSWI (r = 0.65, P = 0.031) were observed on the 2nd POD. Moreover, the patients indicating high PVR values preoperatively showed significantly higher PVR values than those seen in the N group during the postoperative days. Postoperative complications were significantly seen in the PVR group. Primary water and sodium balance tended to be the higher accumulation in the PVR group than those of the N group, and the cardiovascular parameters in the PVR group revealed hypodynamic characteristics in the early period after the operation. With these results, it is suggested that perioperative fluid therapy and respiratory management should be performed more strictly in the PVR group.
Kojima
Y
Y
Department of Surgery, Kansai Medical University, Osaka, Japan.
Hiramatsu
Y
Y
Kitade
H
H
Ogura
T
T
Nakagawa
A
A
Sanada
T
T
Yamanaka
H
H
Kawaguchi
Y
Y
Hioki
K
K
Yamamoto
M
M
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D004938:Esophageal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D004947:Esophagus / Q000601:surgery; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period
D009320:Atrial Natriuretic Factor