Impact of perioperative peripheral blood values on postoperative complications after esophageal surgery.
OBJECTIVE
Prediction of the postoperative course of esophagectomy is an important part of the strict perioperative management of patients undergoing surgery for esophageal cancer.


METHODS
To evaluate their clinical importance, peripheral blood values, including white blood cell count (WBC), lymphocyte count, and the levels of total protein, transferrin, factor XIII, D-dimer, fibrin, and fibrinogen degradation products (FDP) were measured before and after esophagectomy for esophageal cancer in 24 patients.


RESULTS
The preoperative WBC and the pre- and postoperative lymphocyte count were decreased remarkably in patients who received preoperative chemoradiotherapy. The values of perioperative serum transferrin were significantly lower in patients with postoperative pneumonia than in those without. The activity of plasma factor XIII was suppressed on postoperative day (POD) 7 in patients with pneumonia and on POD 14 in patients with leakage.


CONCLUSIONS
These results suggest that patients who receive preoperative chemoradiotherapy are potentially immunosuppressed, the preoperative serum transferrin level is a possible predictive marker of postoperative pneumonia, and suppression of factor XIII activity is related to anastomotic insufficiency.
Saeki
Hiroshi
H
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Masuda
Takanobu
T
Okada
Satoko
S
Ando
Koji
K
Sugiyama
Masahiko
M
Yoshinaga
Keiji
K
Endo
Kazuya
K
Sadanaga
Noriaki
N
Emi
Yasunori
Y
Kakeji
Yoshihiro
Y
Morita
Masaru
M
Yamashita
Natsumi
N
Maehara
Yoshihiko
Y
D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000097:blood* / Q000188:drug therapy / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005176:Factor XIII / Q000032:analysis*; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D011014:Pneumonia / Q000097:blood / Q000209:etiology; D011183:Postoperative Complications / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D013529:Surgical Wound Dehiscence / Q000097:blood / Q000209:etiology; D014168:Transferrin / Q000032:analysis*
D000970:Antineoplastic Agents; D014168:Transferrin; D005176:Factor XIII