Abstract | PURPOSE: To evaluate the efficacy of a proton pump inhibitor, we retrospectively reviewed patients who underwent gastric fiberscopy (GFS) in the early phase after cardiac surgery. METHODS: The subjects were 103 patients who underwent GFS for poor appetite, gastric pain, heartburn, or hematemesis after cardiac surgery. We divided the patients into two groups: group I consisted of 49 patients who received an H2-receptor antagonist ( ranitidine hydrochloride 300 mg/day), and group II consisted of 54 patients who received a proton pump inhibitor (PPI; sodium rabeprazole 10 mg/day) as prophylactic treatment. The incidence of upper gastrointestinal (GI) disease was compared in the two groups. RESULTS: Gastric fiberscopy confirmed that 82.5% of the patients had type I hiatal hernia. The incidences of gastric pain and heartburn were significantly higher in group I (12.2% and 83.7%) than in group II (0% and 37.0%). Moreover, gastric bleeding occurred in two patients from group I, one [corrected] of whom died of coagulopathy. The incidences of hemorrhagic gastritis, active ulcer, and reflux esophagitis were significantly higher in group I than in group II, at 22.4%, 22.4%, and 24.5% vs 1.9%, 0%, and 7.4%. CONCLUSIONS: Early postcardiotomy GFS confirmed a high incidence of type I hiatal hernia. However, the proton pump inhibitor given in the early postoperative period proved more effective than the H2-receptor antagonist for relieving GI symptoms and preventing upper GI disorders after cardiac surgery.
|
Authors | Mitsumasa Hata, Motomi Shiono, Hisakuni Sekino, Hidekazu Furukawa, Akira Sezai, Mitsuru Iida, Isamu Yoshitake, Tsutomu Hattori, Shinji Wakui, Makoto Taoka, Nanao Negishi, Yukiyasu Sezai |
Journal | Surgery today
(Surg Today)
Vol. 36
Issue 2
Pg. 131-4
( 2006)
ISSN: 0941-1291 [Print] Japan |
PMID | 16440158
(Publication Type: Comparative Study, Journal Article)
|
Chemical References |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Benzimidazoles
- Proton Pump Inhibitors
- Rabeprazole
- Ranitidine
- Omeprazole
|
Topics |
- 2-Pyridinylmethylsulfinylbenzimidazoles
- Adult
- Aged
- Aged, 80 and over
- Benzimidazoles
(therapeutic use)
- Cardiac Surgical Procedures
(adverse effects, methods)
- Dose-Response Relationship, Drug
- Drug Administration Schedule
- Female
- Gastroesophageal Reflux
(diagnosis, drug therapy, etiology)
- Gastrointestinal Hemorrhage
(etiology, prevention & control)
- Hernia, Hiatal
(diagnosis, drug therapy, etiology)
- Humans
- Male
- Middle Aged
- Omeprazole
(analogs & derivatives, therapeutic use)
- Patient Satisfaction
- Postoperative Care
- Probability
- Proton Pump Inhibitors
- Rabeprazole
- Ranitidine
(therapeutic use)
- Risk Assessment
- Treatment Outcome
|