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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 | Trends in infectious disease mortality in the US显示文摘 | Teuth SM Berkelman RL | 1996 | JAMA1996，275，： | 1 |
| 3 | Visualization of bilinlinker peptides and proteins in polyacryamids显示文摘 | Berkelman T R Lagaris J C | 1986 | Anal Biochem1986，156，： | 1 |
| 4 | Visualization of Bilin-linked Peptides and Proteins in Polyacrylamide Gels显示文摘 | Berkelman T R Lagarias J C | 1986 | Anal Biochem1986，156，1： | 1 |
| 5 | Public health surveillance in the United States显示文摘 | Thacker SB Berkelman RL | 1988 | Epidemiol Rev1988，10，： | 1 |
| 6 | Visualization of Bilin-Linker Peptides and Proteins in Polyacryamids显示文摘 | Berkelman T R Lagaris J C | 1986 | Anal Biochem1986，156，： | 1 |
| 7 | A modified silver staining protocol for visualization of proteins compatible with matzlx-assisted laser desorption/ionization and electrospray ionizatlon-mass spectrom- etry显示文摘 | Yan J X Wait R Berkelman T | 2000 | Electrophoresis2000，21，17： | 1 |
| 8 | A modified silver staining protocol for visualization of proteins compatible with matrix-assisted laser desorption/ionization and electrospray ionization-mass spectrometry显示文摘 | Yan JX WaitR Berkelman T etal | 2000 | Electrophoresis2000，21，17： | 1 |
| 9 | A modified silver staining protocol for visualization of proteins compatible with matrix-assisted laser desorption/ionization and electrospray ionization-mass spectrometry显示文摘 | Yan JX Wait R Berkelman T | 2000 | Electrophoresis2000，21，17： | 1 |
| 10 | Visualization of bilin - linker peptides and proteins in polyacryamids 显示文摘 | BERKELMAN T R -LAGARIS J C | 1986 | Anal Biochem1986，156，： | 1 |
| 11 | A modified silver staining protocol for visualization of proteins compatible with matrix-assisted laser desorption/ionization and electrospray ionization-mass spectrometry显示文摘 | Yan JX Wait R Berkelman T | 2000 | Electrophoresis2000，21，： | 1 |
| 12 | A review of strategies for enhancing the completeness of notifible disease reporting显示文摘 | SILK B J BERKELMAN R L | 2005 | J Public Health Manag Pract2005，11，3： | 1 |
| 13 | public health surveillance in the United States 显示文摘 | Thacker SB Berkelman RL | 1998 | Epidemiol Rev1998，10，： | 1 |
| 14 | A modified silver staining protocol for visualization of proteins compatible with matrixassisted laser desorption/ionization and electrospray ionizationmass spectrometry显示文摘 | YAN J X WAIT R BERKELMAN T | 2000 | Electrophoresis2000，21，36： | 1 |
| 15 | Increased bactericidal activity of dilute preparations of povidone-jodine solutions 显示文摘 | Berkelman RL Holland BW Anderon RL | 1982 | J Clin Mivrobiol1982，15，4： | 1 |
| 16 | Increasing incidence of legionellosis in the United States, 1990-2005: changing epidemiologic trends 显示文摘 | Neil K Berkelman R | 2008 | Clin infect dis2008，47，： | 1 |
| 17 | A miniature microsurgical instrument tip force sensor for enhanced force feedback during robot-assisted manipulation显示文摘 | Berkelman P J Whitcomb L L Taylor R H | 2003 | IEEE Transactions on Robotics and Automation2003，19，5： | 1 |
| 18 | A modified silver staining protocol for visualization of proteins compatible with matrix-assisted laser desorption/ionization and electrospray ionization-mass spectrometry显示文摘 | Yan J X Wait R Berkelman T | 2000 | Electrophoresis2000，21，17： | 1 |
| 19 | A moditled silver staining protocol for vlsualization of proteins compatible with matrix-assisted laser desorption/ioaization and dectrospray ionization-mass spectrometry 显示文摘 | Yan J X Wait R Berkelman T | 2000 | Electrophoresis2000，21，17： | 1 |
| 20 | A modified silver staining protocol for visualization of p roteins compatible with matrix assisted laser desorption / ionization and electrosp my ionization mass spectrometry 显示文摘 | Yah J X Wait R Berkelman T | 2000 | Electrophoresis2000，21，17： | 1 |
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