• Hepato Gastroenterol · Sep 2011

    Influence of neutrophil elastase inhibitor on the postoperative course in patients with esophageal cancer after transthoracic esophagectomy.

    • Kenji Mimatsu, Takatsugu Oida, Atsushi Kawasaki, Hisao Kano, Youichi Kuboi, and Sadao Amano.
    • Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan. mimatsu.kenji@yakochu.jp
    • Hepato Gastroenterol. 2011 Sep 1; 58 (110-111): 1583-7.

    Background/AimsWe evaluated influence of sivelestat sodium hydrate in the clinical course after transthoracic esophagectomy.MethodologyForty-two consecutive patients with esophageal cancer underwent transthoracic esophagectomy. Twenty-two patients were treated with sivelestat (sivelestat group) and twenty patients were untreated (control group). Sivelestat (0.2 mg/(kg·h)-1) was continuously administered for 5 days since ICU admission. Postoperative morbidity, duration of systemic inflammatory response syndrome (SIRS) and mechanical ventilation, and the time to refilling were examined. The level of serum white blood cells (WBC), C-reactive protein (CRP), aspartate transaminase (AST), alanine aminotransferase (ALT), total bilirubin (TB) and the PaO2/FiO2 ratio were measured.ResultsThe durations of SIRS and mechanical ventilation and the time to refilling were significantly shorter in the sivelestat group than in the control group. Postoperative changes in the serum WBC, CRP, AST and ALT levels were not significantly different between the groups; however, serum TB level was significantly lower in the sivelestat group than in the control group. The PaO2/FiO2 ratio at postoperative day 3 was significantly higher in the former than in the latter.ConclusionsWe demonstrated that sivelestat might contribute to the improvement of acute lung injury, hyperbilirubinemia and postoperative circulatory failure.

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