J.Jpn. Surg. Soc.. 93(9): 977-980, 1992

---

Report on the annual meeting

MANAGEMENT OF PATIENTS WITH IMPAIRED GLUCOSE TOLERANCE FOLLOWING ESOPHAGECTOMY FOR CARCINOMA OF THE ESOPHAGUS

We demonstrated the effectiveness of the “sliding scale” insulin infusion in diabetic patients undergoing esophagectomy. Fifty-eight patients were followed after esophagecotmy to clarify differences in energy expenditure and caloric contributions of substrates. Energy expenditure was measured by indirect calorimetry on the 1st, 3rd, 5th, and 7th days after esophagectomy. Out of 58 patients, 7 were divided into diabetic (D), 30 into borderline (B), 21 into normal (N), according to a 75g oral glucose tolerance test, preoperatively. Forty-four patients underwent esophagectomy by means of right thoracotomy, and blunt esophagectomy was done on 14 patlents.
The results were as follows :
1) No relation was found between postoperative morbidity and severity of glucose intolerance.
2) There was no significant difference in changes in energy expenditure following operation among groups D, B, and N. No difference was found in ratio of caloric intake to energy expenditure among groups D, B, and N. Caloric contributions of substrates seemed to be comparable among groups D, B, and N.
These results suggest that “sliding scale” insulin infusion with total parenteral nutrition enable us to control not only blood glucose level but energy metabolism following esophagectomy in diabetic patients.

---

---

To read the PDF file you will need Adobe Reader installed on your computer.