A case of perioperative artificial pancreas therapy for a patient with esophageal cancer with type 1 diabetes.

IF 1.1 4区 医学 Q4 ENGINEERING, BIOMEDICAL
Journal of Artificial Organs Pub Date : 2024-09-01 Epub Date: 2023-11-29 DOI:10.1007/s10047-023-01423-x
Hiroyuki Kitagawa, Keiichiro Yokota, Tsutomu Namikawa, Hiromichi Maeda, Michiya Kobayashi, Satoru Seo
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Abstract

A 72-year-old female with type 1 diabetes, a history of interstitial pneumonia, and diabetic ketoacidosis was admitted to our hospital with dysphagia. Endoscopy revealed a circumferential neoplastic lesion in the upper to middle esophagus, and a biopsy revealed squamous cell carcinoma. Computed tomography revealed invasion of the left main bronchus, and induction chemotherapy was initiated with a diagnosis of unresectable locally advanced esophageal cancer. After one course of induction chemotherapy, the tumor size reduced, bronchial invasion improved, and thoracoscopic esophagectomy was performed. During surgery and until 3 days after surgery, the patient's blood glucose level was controlled using an artificial pancreas, and the target blood glucose range was set at 140-180 mg/dL. On the fourth postoperative day, the patient was managed using a sliding scale. Mean blood glucose was 186.7 ± 70.0 mg/dL for 3 days before surgery, 190.5 ± 25.0 mg/dL during artificial pancreas therapy from the surgery to the next day, 169.8 ± 22.0 mg/dL during artificial pancreas therapy on the second to third postoperative days, and 174.5 ± 25.0 mg/dL during sliding scale therapy for 4-15 days after surgery. No hypoglycemia or ketoacidosis was noted.

Abstract Image

食管癌合并1型糖尿病围手术期人工胰腺治疗1例。
一名72岁女性,1型糖尿病,间质性肺炎病史,糖尿病酮症酸中毒,因吞咽困难入院。内窥镜检查显示食管上部至中部有一环状肿瘤病变,活检显示鳞状细胞癌。计算机断层扫描显示左主支气管侵犯,诊断为不能切除的局部晚期食管癌,开始诱导化疗。诱导化疗1个疗程后肿瘤缩小,支气管侵犯改善,行胸腔镜食管切除术。术中至术后3天,采用人工胰腺控制患者血糖水平,目标血糖范围为140 ~ 180 mg/dL。术后第四天,采用滑动秤对患者进行管理。术前3天平均血糖为186.7±70.0 mg/dL,手术至次日人工胰腺治疗期间平均血糖为190.5±25.0 mg/dL,术后2 ~ 3天人工胰腺治疗期间平均血糖为169.8±22.0 mg/dL,术后4 ~ 15天滑动秤治疗期间平均血糖为174.5±25.0 mg/dL。无低血糖或酮症酸中毒。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Artificial Organs
Journal of Artificial Organs 医学-工程:生物医学
CiteScore
2.80
自引率
15.40%
发文量
68
审稿时长
6-12 weeks
期刊介绍: The aim of the Journal of Artificial Organs is to introduce to colleagues worldwide a broad spectrum of important new achievements in the field of artificial organs, ranging from fundamental research to clinical applications. The scope of the Journal of Artificial Organs encompasses but is not restricted to blood purification, cardiovascular intervention, biomaterials, and artificial metabolic organs. Additionally, the journal will cover technical and industrial innovations. Membership in the Japanese Society for Artificial Organs is not a prerequisite for submission.
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