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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 | Endocrine metabolic respones to abdominal aortic surgery: a randomized trial of general anesthesia versus general plus epidural anesthesia 显示文摘 | Smeets H J | 1993 | World J Surg1993，17，： | 1 |
| 3 | Analysis of the cell infiltrate and expression of proinflammatory cytokines and matrix metalloprotei- nases in arthroscopic synovial biopsies: comparison with synovial samples from patients with end stage, destructive rheumatoid arthritis 显示文摘 | Smeets T J Barg E C Kraan M C | 2003 | Ann Rheum Dis2003，62，7： | 1 |
| 4 | Reduction of pain catastrophizing mediates the outcome of both physical and cognitive-behavioral treatment inchronic low back pain 显示文摘 | Smeets R J Vlaeyen JW Kester AD | 2006 | J Pain2006，17，： | 1 |
| 5 | Direct NO and N2O decomposition and NO-assisted N2O decomposition over Cu-zeolites: Elucidating the influence of the Cu-Cu distance on oxygen migration 显示文摘 | Smeets P J Groothaert M H van Teeffelen R M | 2007 | J Catal2007，245，： | 1 |
| 6 | Synthesis,X-ray crystal structure and magenetism of (C2H5OH)2-a second example of a ferromagnetically coupled five-coordinated high spin dichloro-bridged nicked(Ⅱ)dimmer显示文摘 | Kolnaar J J A Smeets W J J | 1998 | Eur J Inorg Chem1998，，： | 1 |
| 7 | The parietal epithelial cell is crucially involved in human idiopathic focal segmental glomerulosclerosis显示文摘 | Dijkman H Smeets B van der Laak J Steenbergen E Wetzels J | 2005 | Kidney Int2005，68，： | 1 |
| 8 | The cellular red- ox state as a modulator in cadmium and copper responses in Arabidopsis thaliana seedlings 显示文摘 | Cuypers A Smeets K Ruytinx J | 2011 | Journal of Plant Physiology2011，168，： | 1 |
| 9 | Lithium--metal of the future 显示文摘 | Mahi P Smeets A A J Fray D J | 1986 | Journal of the Minerals Metals and Materials Society1986，38，11： | 1 |
| 10 | Energy expenditure,satiety,and plasma ghre-lin ,glucagon-like peptide l,and peptide tyrosine-tyro-sine concentrations following a single high-proteinlunch 显示文摘 | SMEETS A J’SOENEN S LUSCOMBE-MARSH ND | 2008 | The Journal of Nutrition2008，138，4： | 1 |
| 11 | Proliferating cells in HIV and pamidronate-assoeiated collapsing focal segmental glomerulosclerosis are parietal epithelial cells显示文摘 | Dijkman H B Weening J J Smeets B Verrijp K C van Kuppev elt T H Assmann K K | 2006 | Kidney Int2006，70，： | 1 |
| 12 | Targeting PKC in human T cells using sotrastaurin (AEB071) preserves regulatory T cells and prevents IL-17 production显示文摘 | He X Koenen H J Smeets RL | 2014 | J Invest Demmtol2014，134，4： | 1 |
| 13 | High-density mapping of electrically induced atrial fibrillation in humans 显示文摘 | Konings KT Kirchhof C J Smeets JR | 1994 | Circulation1994，89，4： | 1 |
| 14 | Metabolic remodelling of the failing heart: the cardiac burn-out syndrome 显示文摘 | Vanbilsen M Smeets P J Glide A J | 2004 | Cardiovasc Res2004，61，2： | 1 |
| 15 | Extraction of lithium by vacuum thermal reduction with aluminium and silicon 显示文摘 | Smeets A A J Fray D J | 1991 | Transactions of the Institution of Mining and Metallurgy Section C1991，100，： | 1 |
| 16 | Metabolic re-modeling of the failing heart: the cardiac burn-out syndrome? 显示文摘 | Van Bilsen M Smeets PJ Gilde A J | 2004 | Cardiovase Res2004，61，2： | 1 |
| 17 | Active re habilitation for chronic low back pain: cognitive-beha- vioral, physical, or both? First direct post treatment re suits from a randomized controlled trial显示文摘 | Smeets R J Vlaeyen J W Hidding A | 2006 | BMC Muscu loskelet Disord2006，7，5： | 1 |
| 18 | Direct NO and N2 0 decomposition and NO- assisted Nz 0 decomposition over Cu-zeolites Elucidating the influence of the CtrCu distance on oxygen migration显示文摘 | Smeets P J Groothaer M H Schoonheydt R A | 2007 | J Catal2007，245，2： | 1 |
| 19 | Addition of capsaicin and exchange of carbohydrate with protein counteract energy intake restriction effects on fullness and energy expenditure显示文摘 | SMEETS A J JANSSENS P L WESTERTERP-PLANTENGA M S | 2013 | The Journal of Nutrition2013，143，4： | 1 |
| 20 | Endoctine metabolic response to abdomunal aortic surgery: arandomized trial of general anesthesia versus general plus epidural aneshesia显示文摘 | Smeets H J | 1993 | Wodd Surg1993，17，： | 1 |
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