title: Impact of perioperative peripheral blood values on postoperative complications after esophageal surgery.
abstract: 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.
authors.affiliation: Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Saeki
authors.forename: Takanobu
authors.initials: T
authors.lastname: Masuda
authors.forename: Satoko
authors.initials: S
authors.lastname: Okada
authors.forename: Koji
authors.initials: K
authors.lastname: Ando
authors.forename: Masahiko
authors.initials: M
authors.lastname: Sugiyama
authors.forename: Keiji
authors.initials: K
authors.lastname: Yoshinaga
authors.forename: Kazuya
authors.initials: K
authors.lastname: Endo
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sadanaga
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Emi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kakeji
authors.forename: Masaru
authors.initials: M
authors.lastname: Morita
authors.forename: Natsumi
authors.initials: N
authors.lastname: Yamashita
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Maehara
mesh_terms: 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*
chemical_list: D000970:Antineoplastic Agents; D014168:Transferrin; D005176:Factor XIII