M Chida

M Nishihira

O Araki

S Kobayashi

S Maeda

T Inoue

Y Ito

Y Karube

English

Dokkyo Medical University Repository / 獨協医科大学リポジトリ

第45回獨協医学会学術集会
若年者白内障手術成績の
検討
獨協医科大学　眼科学教室
青瀬雅資，松島博之，後藤憲仁，妹尾　正
【目的】当院で施行した 40 歳未満の若年者白
内障手術の臨床的特長と手術成績について検
討した．
【方法】 対象は 2014 年 1 月 1 日から 2015 年 12
月 31 日までに当院で水晶体再建術を施行した
40 歳未満の症例 51 例 70 眼で，先天および発達
白内障が疑われる症例はすべて除外した．性
別，年齢，眼軸長，白内障の原因と病型，使用
した眼内レンズ（IOL）（単焦点 IOL または多焦
点 IOL），術前後の視力と角膜内皮細胞減少率，
屈折誤差，術中術後合併症を後ろ向きに検討し
た．
【結果】性別は男性 40 例，女性 15 例と男性が
多く，半数以上が 30 歳代で手術を施行してい
た．平均眼軸長は 24.5±1.8 mm で，白内障の原
因はアトピー性白内障が 47 眼と最も多く，白内
障の性状は前嚢下が 33 眼，後嚢下が 17 眼，前
後嚢下が 11 眼，成熟白内障が 6 眼で，核白内障
3 眼であった．使用した IOL は，単焦点 IOL が
55 眼，多焦点 IOL が 15 眼で，約 20％の症例で
多焦点 IOL を挿入していた．視力は術前平均
0.21，術後平均 1.03 で，手術により視力改善を
認めた．7 割以上の症例で ±0.5D 以内の屈折誤
差であったが，5 症例が ±1〜1.5D の屈折誤差を
認めた．角膜細胞減少率は 4.2±8.1％と明らかな
減少は認めなかった．術中合併症として前嚢切
開不連続症例を 3 例 3 眼，超音波乳化吸引中に
クラッツを生じた症例を 1 例 1 眼，後嚢破損を
生じた症例を 1 例 1 眼に認めた．術後合併症と
して網膜剥離を 6 例 7 眼に認め，全症例ともア
トピー白内障の症例であった．
【結論】 若年者白内障手術は術後良好な視力
改善を得られるが，アトピー性白内障が多く，
術後網膜剥離のリスクが高いため注意深い経
過観察が必要である．
Impact of perioperative 
redox balance on long-term 
outcome in patients 
undergoing lung resection.
Dept. General Thoracic Surgery, Dokkyo Medical 
University, Shimotsuga, Japan
Araki O, Ito Y, Nishihira M, Inoue T, Karube Y, 
Maeda S, Kobayashi S, Chida M
??????????：Surgical stress provokes a cytokine storm 
and systemic inflammatory response syndrome, and can also 
affect redox balance during the postoperative course. However, 
whether inflammatory status, especially redox balance, during 
the perioperative period has effects on long-term outcome fol-
lowing surgery for lung cancer remains unclear.
???????：To determine whether redox balance during the 
perioperative period is associated with long-term survival of 
patients after undergoing lung resection.
???????：Consecutive patients who underwent an ana-
tomical lung resection greater than a segmentectomy for non-
small cell lung cancer from January to June 2013 at our insti-
tution were investigated.
The Ethical Committee of Dokkyo Medical University Hos-
pital approved this study（#24043）and all participating patients 
provided informed consent.
Serum was collected during the operation, and on post-op-
erative day （POD） 3 and 7, and the levels of reactive oxygen 
metabolites （d-ROM） and biological antioxidant potential 
（BAP） were measured using FREE carpe diem （Wismerll）.
We analyzed overall survival, relapse, and cause of death.
???????：d-ROM values on POD 3 and 7 were signifi-
cantly increased as compared to those obtained during the op-
eration, whereas BAP did not significantly change after sur-
gery. A receiver operating characteristic curve revealed a 
dROM cut-off value of 327 during the operation in regard to 
all death. AUC was 0.811. Patients with a dROM value of 327 
or less showed significantly superior 3-year survival as com-
pared to those with a greater value （87.5％ vs. 20.0％, p＜
0.001）.
??????????：Surgical stress caused an increase in dROM 
during the postoperative course. The dROM value obtained 
during the operation was correlated with long-term survival of 
patients after undergoing resection for lung cancer. The dROM 
value may be a useful predictor of overall survival after lung 
cancer resection as well as nutrition/inflammatory prognostic 
factors.
92 獨協医誌
19. 20.


Impact of perioperative redox balance on long-term outcome in patients undergoing lung resection

https://dmu.repo.nii.ac.jp/?action=repository_action_common_download&item_id=2137&item_no=1&attribute_id=22&file_no=1

Impact of perioperative redox balance on long-term outcome in patients undergoing lung resection

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