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Use of the ERAS protocol for the perioperative management of open AAA surgery shortened the time before recommencing oral consumption, the postoperative hospital stay, and reduced the medical costs compared to the conventional approach.

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp ultidetector computed tomographic (CT) coronary angiography is used widely to detect coronary artery disease (CAD) because it is accurate and noninvasive. The novel application of the angiographic view has currently improved the clinical feasibility, especially for explaining disease distribution and severity to the patient and for discussing the treatment strategy in conference. 1-3 Single-center studies have reported 30-95% sensitivity and 86-98% specificity for detecting obstructive CAD using 16-detector CT, compared with conventional coronary angiography (CCA) as the reference modality, and 93-97% sensitivity and 95-99% specificity using 64-detector CT. 4,5 In multicenter studies also, 16-detector CT had 89% sensitivity and 65% specificity for detecting CAD in a segment-based analysis, and in a patient-based analysis, 16-detector CT had 98% sensitivity and 54% specificity and 64-detector CT had 85% sensitivity and 90% specificity. 5,6 Thus, 64-detector CT is superior to 16-detector CT in identifying the presence and severity of obstructive CAD, but it increases the patient's radiation exposure when the retrospective electrocardiogram (ECG)-gated helical technique is used, because the helical pitch is smaller and the tube power is higher. Effective doses reported with 64-detector CT (9.5-21.4 mSv) are higher than those reported in 16-detector CT (3.1-9.4 mSv) studies, as well as those required for CCA. 7 CT examination with an effective dose of 10 mSv may increase cancer deaths by approximately 1 in 2,000 cases.