The effects of the early administration of sivelestat sodium, a selective neutrophil elastase inhibitor, on the postoperative course after radical surgery for esophageal cancer.
OBJECTIVE
The goal of this retrospective study was to evaluate the effects of perioperative administration of sivelestat sodium hydrate, a selective neutrophil elastase inhibitor, on the clinical course after radical surgery for esophageal cancer.


METHODS
The effects of sivelestat on postoperative systemic inflammatory reactions and respiratory function were examined in 53 patients who underwent radical surgery for esophageal cancer between April 2004 and March 2005 with (n = 26, sivelestat group) and without (n = 27, control group) the administration of sivelestat.


RESULTS
The average age in the sivelestat group was higher than that in the control group, but there were no other differences in the background factors between the two groups. The postoperative oxygenation (PaO(2)/FiO(2) ratio) did not differ between the groups, but the decrease in oxygen saturation (SpO(2)) was significantly inhibited in the sivelestat group compared with the control group (p < 0.01). A significant inhibition of the increase in the CRP level also occurred in the sivelestat group (p < 0.01). The patients in the sivelestat group were also hospitalized for shorter periods compared to those in the control group.


CONCLUSIONS
The early administration of sivelestat to patients receiving radical surgery for esophageal cancer can inhibit postoperative systemic inflammatory reactions and it might also have a beneficial effect on the prognosis.
Department of Anesthesiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. j-nsym@is.icc.u-tokai.ac.jp
Junichi
J
Nishiyama
Mitsumasa
M
Matsuda
Satoko
S
Ando
Miyoko
M
Hirasawa
Toshiyasu
T
Suzuki
Hiroyasu
H
Makuuchi
D055371:Acute Lung Injury / Q000209:etiology / Q000517:prevention & control; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism; D004938:Esophageal Neoplasms / Q000191:economics / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000191:economics; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D059035:Perioperative Period; D011183:Postoperative Complications / Q000517:prevention & control; D053491:Proteinase Inhibitory Proteins, Secretory / Q000037:antagonists & inhibitors*; D012189:Retrospective Studies; D013449:Sulfonamides / Q000627:therapeutic use*; D015996:Survival Rate
D053491:Proteinase Inhibitory Proteins, Secretory; D013449:Sulfonamides; D002097:C-Reactive Protein; C069195:sivelestat; D010100:Oxygen; D005998:Glycine