title: Influence of neutrophil elastase inhibitor on the postoperative course in patients with esophageal cancer after transthoracic esophagectomy.
abstract: OBJECTIVE
  We evaluated influence of sivelestat sodium hydrate in the clinical course after transthoracic esophagectomy.
  
  
  METHODS
  Forty-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.
  
  
  RESULTS
  The 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.
  
  
  CONCLUSIONS
  We demonstrated that sivelestat might contribute to the improvement of acute lung injury, hyperbilirubinemia and postoperative circulatory failure.
authors.affiliation: Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan. mimatsu.kenji@yakochu.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000201:enzymology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000201:enzymology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D001663:Bilirubin; D005998:Glycine