Nihon Geka Gakkai zasshi
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Nihon Geka Gakkai zasshi · Jan 2011
[Endovascular therapy of abdominal aortic aneurysms: present and future status in Japan].
Since the Ministry of Health, Labor, and Welfare approved Cook's Zenith AAA in 2006, endovascular repair of abdominal aortic aneurysms (AAAs) has become a widespread, acceptable alternative to traditional surgical intervention in Japan, although it lagged far behind Western countries in adopting this technique. The number of patients who undergo endovascular aortic aneurysm repair (EVAR) is now 3,000 annually and it is expected to exceed 4,000 in the near future, which means that more than half of patients with abdominal aortic or iliac arterial aneurysms will undergo EVAR. A paradigm shift has thus emerged in the field of AAA repair, in which surgical graft replacement was the gold standard for more than 50 years. ⋯ EVAR has made it possible to treat high-risk patients because it does not require laparotomy. Therefore, patients who would have been observed without intervention in the past can now benefit from EVAR. In Japan, an extremely aged society, endovascular repair will become a much more common measure for the treatment of patients with AAA.
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Nihon Geka Gakkai zasshi · Nov 2010
Review[Nutritional support to prevent infectious complications after surgery].
The nutritional condition of patients affects the results of surgical treatment. In patients in poor nutritional condition, postoperative complications, length of hospital stay, and mortality rate were reported to increase. Perioperative nutritional management is an important factor in preventing the incidence of postoperative infectious complications. ⋯ The effects of immunonutrition and synbiotics in surgical patients have been discussed in many recent reports. The advantages and disadvantages of nutritional therapy must be understood to provide the most appropriate regimen. This paper reviews the contribution of nutritional support to the prevention of complications after surgery.
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Nihon Geka Gakkai zasshi · Jul 2010
[The role of co-medical staff in surgical treatment from the viewpoint of respiratory therapists].
Appropriate perioperative assessment of respiratory function and subsequent respiratory therapy are mandatory to reduce postoperative pulmonary complications and restore pulmonary reserve function after surgery. Preoperative instructions on smoking cessation, expectoration of sputum or coughing, and respiratory training are also useful to shorten hospital admissions. ⋯ Certified respiratory therapists approved by the Joint Committee on Respiratory Therapy have a particularly important role in performing respiratory therapy. In the near future, interdisciplinary organization and cooperation between various medical staff will be necessary for the smooth management of RSTs in medical institutions.
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Nihon Geka Gakkai zasshi · Jul 2010
[Burden sharing with co-medical personnel in the surgical area: present and future situations. The clinical engineer's position].
It has been 22 years since clinical engineers first made their appearance as experts in medical equipment used to save patients' lives. At that time, legal revisions, ministerial ordinances, and regulations were established, with the final step awaiting a change in the medical environment. The pressing problem of a serious shortage of physicians is now apparent. ⋯ In current surgical procedures, clinical engineers are necessary to operate various high-risk therapeutic equipment such as therapeutic surgical and life support devices. Clinical engineers work not only in the control of life support devices but also in expanded fields in perioperative care. A revision of the clinical engineer's role in perioperative care and work guidelines is needed so that their fundamental strengths can promote such goals as improved medical safety and a reduction in the burden on physicians and other medical personnel.