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[in Japanese]

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Background : Surgical site infection (SSI) frequently occurs after colorectal surgery. It is well-known that perioperative nutritional management is effective in case of SSI. It has recently been reported that prolyl-hydroxyproline in collagen peptides promotes wound healing. In the present study, we investigated perioperative safety and efficacy of the peptidecontaining formulation PN-2.
Methods : We recruited 20 patients with colorectal cancer in whom surgical resection was planned. They were randomly divided into 2 groups, group A (n = 10) and group B (n = 10). Group A was administered 37.5 g/day of PN-2 for 7 days before and after surgery. Group B was not administered PN-2. The Common Terminology Criteria for Adverse Events (CTCAE, version 4.0) were used to assess the safety of PN-2. Physical measurements, blood tests (hematometry, blood chemistry, cytokine levels, and aminograms), and quality of life (QOL) were assessed before intervention (point 1), i.e., just before surgery (point 2) and after intervention (point 3).
Results : Regarding the safety of PN-2, adverse events such as grade 3.5 CTCAE were not observed. The serum levels of hydroxyproline and total protein were significantly higher in group A [mean, 16.2 (7.7.57.7) and mean, 6.9 (6.0.7.5), respectively] compared to the levels in group B [mean, 12.35 (10.2.18.5) and mean, 6.2 (5.5.7.3), respectively]. Furthermore, other nutritional parameters such as albumin and prognostic nutritional indices were well-maintained postoperatively in group A.
Conclusion : Our findings suggest that in patients with colorectal cancer, PN-2 may be safely administered perioperatively ; moreover, it may improve nutritional status and promote wound healing.

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Objective : ESSENSE (acronym for ESsential Strategy for Early Normalization after Surgery with patient's Excellent satisfaction) project clarifies four basic principles in perioperative management for patients to have a better and quick recovery after major surgery.
The aim of this study was to evaluate the efficacy of enhanced recovery after surgery (ERAS) programs based on the ESSENSE project for patients undergoing open abdominal aortic aneurysm (AAA) repair.
Methods : Patients with AAA scheduled for open AAA repair were randomly assigned to perioperative management with conventional care (control group) or an ERAS program (ERAS group).
Results and Conclusions : There was no statistically significant difference in patient characteristics, duration of operation, anesthesia and aortic clamping, and blood loss between the control group (n=28) and ERAS group (n=30). The average days to the first passage of flatus was shorter in the ERAS group, and performance status improved more quickly in the ERAS group than in the control group. Morbidity was significantly lower (35% vs. 64% ; p<0.05) and the length of postoperative stay was significantly shorter (median 11 days, range 8-25 vs. median 12.5 days, range 8-62 ; p<0.05) in the ERAS group compared to the control group. C-reactive protein was significantly lower at post-operative days 2, 3 and 5 in the ERAS group.
This study shows that the ERAS protocol for the treatment of AAA enhanced the recovery of bowel function and improved physical performance following open AAA repair, and it was a safe and feasible protocol leading to decreased hospital stay.

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[in Japanese]

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