Acta Medica Okayama volume74 issue5
2020-10 発行

Comprehensive Prospective Analysis of the Factors Contributing to Aspiration Pneumonia Following Endoscopic Submucosal Dissection in Patients with Early Gastric Neoplasms

Togo, Masaaki Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Akazawa, Yuko Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Akashi, Taro Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Yamashita, Rika Oral Care Center, Nagasaki University Hospital
Yoshitomi, Izumi JCHO Isahaya General Hospital
Ohba, Kazuo JCHO Isahaya General Hospital
Hashimoto, Satsuki JCHO Isahaya General Hospital
Iwashita, Hiroko JCHO Isahaya General Hospital
Kurogi, Tadafumi Oral Care Center, Nagasaki University Hospital
Osada, Yukiko Dental Hygienist's Office, Department of Medical Technology, Nagasaki University Hospital
Wada, Noriko Dental Hygienist's Office, Department of Medical Technology, Nagasaki University Hospital
Imamura, Yoshifumi Department of Respiratory Medicine, Nagasaki University Hospital
Hashiguchi, Keiichi Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Yamaguchi, Naoyuki Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Kondo, Hisayoshi Biostatistics Section, Division of Scientific Data Registry, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Medicine
Nakao, Kazuhiko Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences
Publication Date
2020-10
Abstract
Endoscopic submucosal dissection (ESD) has become the first-line treatment for early gastric neoplasms; however, a subset of patients treated by this method develop aspiration pneumonia. We conducted a comprehensive prospective analysis of the factors contributing to post-ESD aspiration pneumonia in early gastric neoplasms in this study, with special focus on whether pre-treatment oral care can prevent aspiration pneumonia. Sixty-one patients who underwent ESD for gastric neoplasms were randomly assigned to the oral care or control groups. ESD was performed under deep sedation. Of 60 patients whose data were available for analysis, 5 (8.3%) experienced pneumonia confirmed either by chest radiography or computed tomography. Although no difference in the rate of pneumonia was found between the control and oral care groups, the post-oral care bacteria count was significantly higher in the saliva of patients who developed pneumonia compared to those without pneumonia. In addition, the presence of vascular brain diseases and the dose of meperidine were also significantly associated with the occurrence of pneumonia. These results suggest that the number of oral bacteria as well as pre-existing vascular brain diseases and high-dose narcotics can affect the incidence of post-ESD pneumonia.
Document Type
Original Article
Keywords
endoscopy
oral bacteria
respiratory disease
pneumonia
sedation
Link to PubMed
74_5_407.pdf 2.16 MB