Perioperative Management to Prevent Postoperative Pulmonary Embolism in General Surgical Patients / 日本農村医学会雑誌

Recently, the incidence of pulmonary embolism (PE) after surgery began to increase in Japan and to prevent PE has become essentially important. During the period between July 2003 and August 2004, we placed 203 general surgical patients under our perioperative management using intermittent pneumatic compression (IPC) and compression stockings (CS). We evaluated the effect of our management on the prevention of postoperative PE in those patients. The incidence of PE, prognosis, complications, patient's complaints, cost-benefit were examined. No fatal PE occurred. One patient with low SpO2 had a chest pain and dyspnea but pulmonary scintigrams revealed no PE. Two other patients had contact dermatitis by CS and another patient using an epidural catheter suffered temporary paraplegia after heparin injection. The government has approved a fee for PE prophylaxis since April 2004. Our management using IPC and CS for PE prophylaxis after surgery proved to be an effective in reducing the risk of PE. However, we must take the atmost care in injecting heparin into patients with epidural catheters.

Evaluation of Quality of Life in Patients with Breast Cancer Treated with Chemotherapy / 日本農村医学会雑誌

Recently the evaluation of health-related quality of life (QOL) in cancer patients has become important in carrying out a treatment strategy. During a period between June and August 2004, we studied the QOL in 16 breast cancer patients with or without chemotherapy. The regimens of chemotherapy were EC (n=6), AT (n=1) and CMF (n=1). We made the Functional Assessment of Cancer Therapy Scale-General (FACT-G) in all patients. The patients treated without chemotherapy were superior to those with chemotherapy with respect to physical and emotional well-being (p<0.05). There were no differences in social well-being and relationship to families between the two groups. The patients treated without chemotherapy made significantly higher scores in the basic activities of daily living than those with chemotherapy (p<0.05). Compared with patients receiving chemotherapy, patients treated without chemotherapy had better quality of life (p<0.05). We concluded that it was important for us to assist in decision making about treatment and supportive care needs.