• Akihiro Takata, Shuji Takiguchi, Kohei Murakami, Yasuhiro Miyazaki, Hiroshi Miyata, Tsuyoshi Takahashi, Yukinori Kurokawa, Makoto Yamasaki, Kiyokazu Nakajima, Masaki Mori, Kenji Kangawa, and Yuichiro Doki.
• Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2 E2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
• Surg. Today. 2015 Aug 1; 45 (8): 1025-31.

PurposeGhrelin is a unique gastric hormone, which has pleiotropic biological functions, including anti-inflammatory effects. The aim of this study was to investigate the effects of administering ghrelin on reducing postoperative systemic inflammation in patients undergoing esophagectomy.MethodsThe safety and effectiveness of postoperative ghrelin administration were investigated among twenty esophageal cancer patients who underwent esophagectomy between May 2010 and August 2011. Two different regimens of ghrelin administration, twice daily rapid drip infusion (3 μg/kg, twice a day) or continuous infusion (0.5 μg/kg/h), were employed. The duration of the systemic inflammatory response syndrome (SIRS) and the hematological parameters were compared between groups.ResultsPatients treated with ghrelin showed shorter SIRS durations than controls (1.6 ± 2.7 vs. 4.1 ± 3.7 days, respectively; p = 0.0065) and also showed lower C-reactive protein concentrations than controls (11.0 ± 4.6 mg/dL vs. 15.3 ± 7.3 mg/mL, respectively, on postoperative day 3, p = 0.030). Ghrelin administration was not associated with any adverse events. The incidence of operative morbidity was equivalent between groups. The two ghrelin administration regimens showed similar durations of systemic inflammatory response (rapid drip: 2.2 ± 3.3 vs. continuous: 1.1 ± 1.9 days, p = 0.17).ConclusionsPostoperative ghrelin administration is safe and may suppress protracted postoperative inflammation in patients who undergo esophagectomies.

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