title: Preventive effect of sivelestat on postoperative respiratory disorders after thoracic esophagectomy.
abstract: OBJECTIVE
  Sivelestat, a selective inhibitor of neutrophil elastase, has been reported to reduce acute lung injury associated with systemic inflammatory response syndrome. This study retrospectively investigated the effect of sivelestat on respiratory function in patients who underwent esophagectomy.
  
  
  METHODS
  Patients who underwent esophagectomy for thoracic esophageal cancer between 2005 and 2010 were included in this study. Forty-two were treated perioperatively with sivelestat (4.8 mg/kg/day; sivelestat group) and the remaining 35 were not (control group). Sivelestat was administered continuously from the beginning of surgery until postoperative day 3. All patients were administered methylprednisolone for 3 days. The perioperative clinical and laboratory data, total sequential organ failure assessment score, PaO2/FiO2 ratio (P/F ratio) and postoperative complications were compared between the two groups.
  
  
  RESULTS
  There were no significant differences between the groups in the patients' background data. The P/F ratio immediately after surgery was significantly higher in the sivelestat group than in the control group (p < 0.05). The respiratory rate immediately after surgery and the temperature on postoperative day 2 were significantly lower in the sivelestat group than in the control group (p < 0.05). There were no differences in any of the other clinical data or complications.
  
  
  CONCLUSIONS
  Perioperative administration of sivelestat improves postoperative respiratory function in patients after esophagectomy.
authors: Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto, Kumamoto 860-8556, Japan. gookojapan@yahoo.co.jp
authors: Yohei
authors: Y
authors: Nagai
authors: Masayuki
authors: M
authors: Watanabe
authors: Yoshihumi
authors: Y
authors: Baba
authors: Masaaki
authors: M
authors: Iwatsuki
authors: Kotaro
authors: K
authors: Hirashima
authors: Ryuichi
authors: R
authors: Karashima
authors: Jyunji
authors: J
authors: Kurashige
authors: Koichi
authors: K
authors: Kinoshita
authors: Hideo
authors: H
authors: Baba
mesh_terms: D055371:Acute Lung Injury / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005998:Glycine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control*; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use*; D013449:Sulfonamides / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D015842:Serine Proteinase Inhibitors; D013449:Sulfonamides; C069195:sivelestat; D005998:Glycine; D008775:Methylprednisolone