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01-04-2013 | Original Article

Preventive effect of sivelestat on postoperative respiratory disorders after thoracic esophagectomy

Authors: Yohei Nagai, Masayuki Watanabe, Yoshihumi Baba, Masaaki Iwatsuki, Kotaro Hirashima, Ryuichi Karashima, Jyunji Kurashige, Koichi Kinoshita, Hideo Baba

Published in: Surgery Today | Issue 4/2013

Abstract

Purpose

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.

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Title: Preventive effect of sivelestat on postoperative respiratory disorders after thoracic esophagectomy
Authors: Yohei Nagai
Masayuki Watanabe
Yoshihumi Baba
Masaaki Iwatsuki
Kotaro Hirashima
Ryuichi Karashima
Jyunji Kurashige
Koichi Kinoshita
Hideo Baba
Publication date: 01-04-2013
Publisher: Springer Japan
Published in: Surgery Today / Issue 4/2013
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-013-0508-6

At a glance: The STEP trials

Springer Medicine

Preventive effect of sivelestat on postoperative respiratory disorders after thoracic esophagectomy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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