Marked and prolonged depression of Factor XIII after esophageal resection

Saito, Hideaki; Kobori, Oichiro; Kawano, Nobuhiro; Muto, Tetsuichiro; Morioka, Yasuhiko

doi:10.1007/bf00308823

Cited by 10 publications

(7 citation statements)

References 13 publications

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“…The fistula usually dried up within 5 days [2]. Factor XIII has been recognized as an important wound-healing factor, and the administration of factor XIII enhances the granulation of surgical wounds in clinical and experimental studies [5]. In our case, human antihemolytic factor XIII was given intravenously, and complete healing of the esophago-pleura-cutaneous fistula was accomplished within 6 days of the removal of the T-tube.…”

Section: Discussionmentioning

confidence: 89%

Successful Late Management of Esophageal Perforation with T-Tube Drainage

Nakabayashi

Kudo

Hirasawa³

et al. 2008

Case Rep Gastroenterol

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The late management of spontaneous esophageal perforation is the most challenging problem for the surgeon. In this paper, we present a case in whom a spontaneous esophageal perforation was successfully treated by T-tube drainage after unsuccessful conservative treatment. The patient, a 68-year-old male, was admitted to the hospital with sudden upper abdominal pain. After 2 days, esophageal perforation was diagnosed, and conservative management was begun. Thereafter, the subcutaneous emphysema disappeared, and the patient’s temperature decreased. However, on day 13, the patient’s temperature spiked above 38°C, and computed tomography showed a mediastinal abscess. An emergency left thoracotomy with laparotomy was performed. Since a 2-cm longitudinal perforation with severe inflammatory reactions was observed, the T-tube drainage method was performed. The patient was discharged without postoperative complications and has not experienced any gastrointestinal symptoms, such as gastroesophageal reflux or dysphagia. In conclusion, the T-tube drainage method appears to be a simple and effective method for the late management of esophageal perforation with severe inflammatory reaction.

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Section: Discussionmentioning

confidence: 89%

Successful Late Management of Esophageal Perforation with T-Tube Drainage

Nakabayashi

Kudo

Hirasawa³

et al. 2008

Case Rep Gastroenterol

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“…Therefore, clinical manifestations are unreliable indicators of pneumothorax size (44). Additionally, plasma factor XIII has been reported to be a fistula-healing factor and intraoperative bleeding (29,30,45,46). In lung disease, there are some reports related to therapeutic effect of pneumothorax and prolonged air leak after pulmonary lobectomy (47,48).…”

Section: Discussionmentioning

confidence: 99%

“…The secondary goal was to assess the risk factors of manual aspiration failure. This study had some novelties: (I) the indication was independent of the degree of collapse or etiology in clinically stable patients; (II) small needles (20-22-G) were used; (III) aspiration was attempted thrice; (IV) intrathoracic pressure was measured; (V) serum plasma factor XIII was measured (29,30); and (VI) the factors of manual aspiration failure was assessed.…”

Section: Original Articlementioning

confidence: 99%

Effectiveness and failure factors of manual aspiration using a small needle for large pneumothorax in stable patients

Homma¹,

Ojima²,

Shimada³

et al. 2022

J Thorac Dis

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Background: Manual aspiration as the initial management of a large pneumothorax in a clinically stable patient has been reported to be safe and effective. However, the effect with smaller needles, the number of aspiration, the indication other than spontaneous pneumothorax and failure factors are unknown. We assessed the effectiveness and failure risk factors of manual aspiration up to three using a 20-or 22-gauge (G) needle in patients with a large, clinically stable pneumothorax.Methods: We included 107 clinically stable patients with large pneumothorax. Patients who were unstable, required a ventilator, underwent chest tube drainage or had an observed small pneumothorax, bilateral pneumothorax, hemopneumothorax, or postoperative pneumothorax were excluded. Up to three aspirations were performed using 20-or 22-G intravenous needles. When the aspiration volume was ≥2,500 mL or lung expansion did not occur, a chest tube was placed. Results:The first aspiration was successful in 57 patients (53.3%), the second in 16 patients (59.3%), and the third in eight patients (80.0%). No patient experienced any obvious complications or required emergent hospitalization or surgery after aspiration. Aspiration failure was correlated with an inter-pleural distance >20 mm at the level of the hilum (odds ratio: 4.93; 95% confidence interval: 1.49-22.71; P=0.0075), spontaneous secondary pneumothorax (odds ratio: 3.11; 95% confidence interval: 1.14-8.76; P=0.027), and ≤24 h from onset to presentation (odds ratio: 2.95; 95% confidence interval: 1.12-8.26; P=0.028). There were no significant differences in intrathoracic pressure after aspiration or plasma factor XIII levels between patients with resolved and persistent pneumothorax.Conclusions: Manual aspiration up to three times using a small needle might be one of a treatment option in clinically stable patients with any large pneumothorax. Aspiration failure was correlated with an inter-pleural distance >20 mm at the level of the hilum, spontaneous secondary pneumothorax, and ≤24 h from onset to presentation.

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“…Prolonged reduction in plasma FXIII levels following surgery has been demonstrated [18,23,54,55] and FXIII supplementation reduced the incidence of post-operative complications including disturbed wound healing [18,[23][24][25]. In 70% of patients with prolonged air leak following pulmonary lobectomy, air leaks resolved when FXIII was administered for five days.…”

Section: Surgical Wound Healingmentioning

confidence: 99%

The impact of acquired coagulation factor XIII deficiency in traumatic bleeding and wound healing

et al. 2022

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Factor XIII (FXIII) is a protein involved in blood clot stabilisation which also plays an important role in processes including trauma, wound healing, tissue repair, pregnancy, and even bone metabolism. Following surgery, low FXIII levels have been observed in patients with peri-operative blood loss and FXIII administration in those patients was associated with reduced blood transfusions. Furthermore, in patients with low FXIII levels, FXIII supplementation reduced the incidence of post-operative complications including disturbed wound healing. Increasing awareness of potentially low FXIII levels in specific patient populations could help identify patients with acquired FXIII deficiency; although opinions and protocols vary, a cut-off for FXIII activity of ~ 60–70% may be appropriate to diagnose acquired FXIII deficiency and guide supplementation. This narrative review discusses altered FXIII levels in trauma, surgery and wound healing, diagnostic approaches to detect FXIII deficiency and clinical guidance for the treatment of acquired FXIII deficiency.

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Marked and prolonged depression of Factor XIII after esophageal resection

Cited by 10 publications

References 13 publications

Successful Late Management of Esophageal Perforation with T-Tube Drainage

Successful Late Management of Esophageal Perforation with T-Tube Drainage

Effectiveness and failure factors of manual aspiration using a small needle for large pneumothorax in stable patients

The impact of acquired coagulation factor XIII deficiency in traumatic bleeding and wound healing

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