Abstract
A 72-year-old female with type 1 diabetes, a history of interstitial pneumonia, and diabetic ketoacidosis was admitted to our hospital with dysphagia. Endoscopy revealed a circumferential neoplastic lesion in the upper to middle esophagus, and a biopsy revealed squamous cell carcinoma. Computed tomography revealed invasion of the left main bronchus, and induction chemotherapy was initiated with a diagnosis of unresectable locally advanced esophageal cancer. After one course of induction chemotherapy, the tumor size reduced, bronchial invasion improved, and thoracoscopic esophagectomy was performed. During surgery and until 3days after surgery, the patient's blood glucose level was controlled using an artificial pancreas, and the target blood glucose range was set at 140-180mg/dL. On the fourth postoperative day, the patient was managed using a sliding scale. Mean blood glucose was 186.7 ± 70.0mg/dL for 3days before surgery, 190.5 ± 25.0mg/dL during artificial pancreas therapy from the surgery to the next day, 169.8 ± 22.0mg/dL during artificial pancreas therapy on the second to third postoperative days, and 174.5 ± 25.0mg/dL during sliding scale therapy for 4-15days after surgery. No hypoglycemia or ketoacidosis was noted.
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Schedule a callMore From: Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs
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