title: Preventive effect of ulinastatin on postoperative complications, immunosuppression, and recurrence in esophagectomy patients.
abstract: BACKGROUND
  To evaluate the potential efficacy of preventive effect of ulinastatin in esophagectomy patients.
  
  
  METHODS
  Eighty patients with esophageal cancer were preoperatively allocated at random into two equal groups. Ulinastatin was administered to the treatment group (U) whereas the control group (C) received a placebo. The arterial oxygen tension and carbon dioxide tension were measured and the respiratory index (RI) was calculated. Plasma levels of circulating T lymphocyte subsets and interleukin 6 (IL-6) were measured and clinical courses of patients in the two groups were compared.
  
  
  RESULTS
  RI in the U group was significantly lower than that in the C group. The rate of postoperative complications and the duration of ICU stay were significantly lower in the U group. Ulinastatin significantly increased the rate of CD3+ and CD4+ cells, and ratio of CD4+/CD8+, but decreased the rate of CD8+ cells and release of IL-6 compared to the C group on postoperative days 1 and 3. Patients within the C group showed worse recurrence free survival. Multivariate analysis revealed that ulinastatin administration significantly decreased the incidence of recurrence.
  
  
  CONCLUSIONS
  Ulinastatin had a preventive effect on postoperative complications and immunosuppression in esophagectomy patients, thereby prolongingrecurrence free survival.
authors.affiliation: Department of Anesthesiology, First Affiliated Hospital, Medical School, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
authors.forename: Lingmin
authors.initials: L
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Wang
authors.forename: Suna
authors.initials: S
authors.lastname: Zhou
authors.forename: Wenguang
authors.initials: W
authors.lastname: Ye
authors.forename: Qinglin
authors.initials: Q
authors.lastname: Yao
authors.forename: Guixia
authors.initials: G
authors.lastname: Jing
authors.forename: Mingxin
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000378:metabolism; D016022:Case-Control Studies; D004938:Esophageal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D016629:Esophagectomy / Q000009:adverse effects* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006023:Glycoproteins / Q000627:therapeutic use*; D006801:Humans; D007108:Immune Tolerance / Q000187:drug effects; D007165:Immunosuppression Therapy; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D009367:Neoplasm Staging; D010100:Oxygen / Q000378:metabolism; D011183:Postoperative Complications / Q000517:prevention & control*; D011379:Prognosis; D015656:Respiratory Mechanics; D015996:Survival Rate; D016176:T-Lymphocyte Subsets / Q000187:drug effects*; D014361:Trypsin Inhibitors / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D006023:Glycoproteins; D015850:Interleukin-6; D014361:Trypsin Inhibitors; D002245:Carbon Dioxide; C028665:urinastatin; D010100:Oxygen