J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1689KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 91(9): 1186-1190, 1990

Report on the annual meeting

ENDOCRINLOGICAL RESPONSES OF THE SEVERE DIABETES MELLITUS AFTER CANCER OPERATION

1) Department of Gastroenterological Sungery, School of Medicine, Fujita-Gakuen University, Toyoake, Japan
2) Department of Surgery, Yokkaichi-chuo Hospital, Yokkaichi, Japan
3) Department of Surgery, Junwa Hospital, Nagoya, Japan
4) First Department of Surgery, Sapporo Medical College, Sapporo, Japan

Shiro Fukui1), Haruo Aoki1), Yasuhiro Mizushima2), Yasumasa Suzuki2), Atsushi Ikeyama3), Shigeru Maeda3), Hiroshi Hayasaka4)

Endocrinological responses of the total 181 patients with the severe diabetes mellitus are investigated in the prior and postoperative period. The 61 patients were maintained with the total parenteral nutrition (TPN), and the 160 were not maintained with the TPN. In both groups, blood sugar level was controlled by the insulin administration. Endocrinological substances, protein metabolism, and glucose were measured in the pre and post operative period.
Results : the endocrinological response during catabolic phase just after operation were divided into 3 groups as well, faire, and poor, respectively. The increases in noradrenalin, ACTH, cortisol and IRG were well correlated to the increases in the N-B, the catabolic index (CI), RTP and A1b. The 20g IVGTT showed suppressed ΣIRI/ΣIRG in the poor group. The decreases in CI, noradrenalin, N-B, RTP were also found in this catabolic phase. Endocrine response with the insulin-IVTT increased in the well group, however, no marked increase was found in the poor group. The well responses of the endocrine substances were found in light DM group at the 60 min after InsIVTT, while the severe DM cases showed the poor responses. Endocrinological balances showed the marked abnormalities. Preoperative TPN with the insulin administration may prevent the metabolic abnormalities.

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