nach oben

Surgery Today

Erschienen in:

01.07.2012 | Original Article

The effects of the early administration of sivelestat sodium, a selective neutrophil elastase inhibitor, on the postoperative course after radical surgery for esophageal cancer

verfasst von: Junichi Nishiyama, Mitsumasa Matsuda, Satoko Ando, Miyoko Hirasawa, Toshiyasu Suzuki, Hiroyasu Makuuchi

Erschienen in: Surgery Today | Ausgabe 7/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

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 (PaO₂/FiO₂ ratio) did not differ between the groups, but the decrease in oxygen saturation (SpO₂) 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.

Conclusion

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.

Nakae H, Endo S, Inada K, Kasai T, Yoshida M. Significance of α-tocopherol and interleukin 8 in septic adult respiratory distress syndrome. Res Commun Chem Pathol Pharmacol. 1994;84:197–202.PubMed

Endo S, Inada K, Inoue Y, Kuwata Y, Suzuki M, Yamashita H, et al. Two types of septic shock classified by the plasma levels of cytokines and endotoxin. Circ Shock. 1992;38:264–74.PubMed

Endo S, Inada K, Yamada Y, Kasai T, Takakuwa T, Nakae H, et al. Plasma tumor necrosis factor-α (TNF-α) levels in patients with burns. Burns. 1993;19:124–7.PubMedCrossRef

Endo S, Inada K, Yamashita H, Takakuwa T, Nakae H, Kasai T, et al. Platelet activating factor (PAF) acetylhydrolase activity type II phosholipase A₂, and cytokine levels in patients with sepsis. Res Commun Chem Pathol Pharmacol. 1994;83:289–95.PubMed

Endo S, Inada K, Ceska M, Takakuwa T, Yamada Y, Nakae H, et al. Plasma interleukin 8 and polymorphonuclear leukocyte elastase concentrations in patients with septic shock. J Inflammation. 1995;45:136–42.

Tanaka T, Sugimoto H, Yoshikawa T, Sugimoto T. Role of granulocyte elastase in tissue injury in patients with septic shock complicated by multiple-organ failure. Ann Surg. 1991;213:81–5.PubMedCrossRef

Petty TL. Protease mechanisms in the pathogenesis of acute lung injury. Ann NY Acad Sci. 1991;624:267–77.PubMedCrossRef

Yachida S, Wakabayashi H, Kokudo Y, Goda F, Okada S, Maeba T, et al. Measurement of serum hyaluronate as a predictor of human liver failure after major hepatectomy. World J Surg. 2000;24:359–64.PubMedCrossRef

Committee for Preparation of ARDS Guidelines of the Japanese Respiratory Society. Guidelines for Treatment of ALI/ARDS, Tokyo: Shujunsha; 2005.

10.

Hyoba R, Satomi S. Changes in cytokines after surgery for esophageal cancer. Rinshogeka (Jpn J Clin Surg). 1997;52:583–9. (in Japanese).

11.

Sakamoto K, Arakawa H, Mita S, Ishiko T, Ikei S, Egami H, et al. Elevation of circulating interleukin 6 after surgery: factors influencing the serum level. Cytokine. 1994;6:181–6.PubMedCrossRef

12.

Sato N, Hida K, Ikeda K, Oysuka K, Kimura Y, Aoki K, et al. Effect of preoperative methylprednisolone on esophageal surgical stress. Nihon Syokakigeka Gakkaizasshi (Jpn J Gastroenterol Surg). 1997;30889:1831–8. (in Japanese).CrossRef

13.

Yoshida K, Nishihira T, Hyoba R, Nakano T, Akaishi T, Hirayama K, et al. Administration experience of urinastatin in cases ofoperation of thoracic esophagus cancer cases. Renal function and granulocytic elastase. Rinshotokenkyu (Jpn J Clin Exp Med) 1990;67: 2601–04 (in Japanese).

14.

Ono S, Aosasa S, Mochizuki H. Effects of protease inhibitor on reduction of surgical stress in esophagectomy. Am J Surg. 1999;177:78–82.PubMedCrossRef

15.

Arakawa H, Iwakoshi H, Sakamoto K. Changes in interleukin-8 (IL-8) and neutrophil elastase in bronchoalveolar lavage (BAL) after surgery for esophageal cancer. Biotherapy. 1993;7:736–8. (in Japanese).

16.

Reid PT, Donnnelly SC, MacGregor IR, Grant IS, Cameron E, Walker W, et al. Pulmonary endothelial permeability and circulating neutrophil–endothelial markers in patients undergoing esophagogastrectomy. Crit Care Med. 2000;28:3161–5.PubMedCrossRef

17.

Weiss SJ, Curnutte JT, Regiani S. Neutrophil-mediated solubilization of the subendothelial matrix: oxidative and nonoxidative mechanisms of proteolysis used by normal and chronic granulomatous disease phagocytes. J Immunol. 1986;136:636–41.PubMed

18.

Doi K, Yamanaka K, Tsuneyoshi H. Effectiveness of Sivelestat sodium at the postoperative management against acute lung injury after type a acute aortic dissection. Prog Med. 2006;26:2264–6. (in Japanese).

19.

Nishibe T, Kondo Y, Muto A, Dardik A, Ohara Y, Kainuma M, et al. Protective effect of sivelestat sodium (Elaspol^®) on postoperative lung dysfunction in patients with type A acute aortic dissection: a pilot study. J Cardiovasc Surg (Torino). 2008;49:627–31.

20.

Furusawa T, Tsukioka K, Fukui D, Sakaguchi M, Seto T, Terasaki T, et al. The effects of a neutrophil elastase inhibitor on the postoperative respiratory failure of acute aortic dissection. Thorac Cardiovasc Surg. 2006;54:404–7.PubMedCrossRef

21.

Ryugo M, Sawa Y, Takano H, Matsumiya G, Iwai S, Ono M, et al. Effect of a polymorphonuclear elastase inhibitor (sivelestat sodium) on acute lung injury after cardiopulmonary bypass: findings of a double-blind randomized study. Surg Today. 2006;36:321–6.PubMedCrossRef

22.

Minami T, Kashira K. Usefulness of perioperative sivelestat sodium in thoracic aorta replacement. Masui (Jpn J Anesthesi). 2006;55:977–82. (in Japanese).

23.

Drug interview form ‘Elaspol 100 for injection’, revised in August 2005. 5th edn. p. 24.

24.

Kadota Y, Nakura H, Ichikawa K, Mitaka C. Respiratory management patients after surgery for esophageal cancer in ICU. Rinshomasui (Jpn J Clin Anesth). 1997;21:1049–54. (in Japanese).

25.

Takemura M, Osugi H, Ri E, Kaneko M, Tanaka Y, Fujiwara Y, et al. Trial of invasion reduction in esophageal cancer complete cure excision by elastase inhibitor. Rinshoto kenkyu (Jpn J Clin Exp Med). 2003;80:2289–92. (in Japanese).

26.

Ono S, Tsujimoto H, Hiraki S, Takahata R, Kimura A, Kinoshita M, Ichikura T, Mochizuki H. Effects of neutrophil elastase inhibitor on progression of acute lung injury following esophagectomy. World J Surg. 2007;31:1996–2001.PubMedCrossRef

27.

Sasajima K, Futami R, Matsutani T, Nomura T, Makino H, Maruyama H, Miyashita M. Increases in soluble tumor necrosis factor receptors coincide with increases in interleukin-6 and proteinases after major surgery. Hepatogastroenterology. 2009;56:1377–81.PubMed

28.

Suda K, Kitagawa Y, Ozawa S, Miyasho T, Okamoto M, Saikawa Y, Ueda M, Yamada S, Tasaka S, Funakoshi Y, Hashimoto S, Yokota H, Maruyama I, Ishizaka A, Kitajima M. Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy. Dis Esophagus. 2007;20:478–86.PubMedCrossRef

29.

Akamoto S, Okano K, Sano T, Yachida S, Izuishi K, Usuki H, Wakabayashi H, Suzuki Y. Neutrophil elastase inhibitor (sivelestat) preserves antitumor immunity and reduces the inflammatory mediators associated with major surgery. Surg Today. 2007;37:359–65.PubMedCrossRef

30.

Kawahara Y, Ninomiya I, Fujimura T, Funaki H, Nakagawara H, Takamura H, Oyama K, Tajima H, Fushida S, Inaba H, Kayahara M. Prospective randomized controlled study on the effects of perioperative administration of a neutrophil elastase inhibitor to patients undergoing video-assisted thoracoscopic surgery for thoracic esophageal cancer. Dis Esophagus. 2010;23:329–39.PubMedCrossRef

31.

Hoshi K, Yamamoto Y, Shibusawa M, Saito K, Agatsuma T, Kameyama Y, et al. The fluctuation of the circulatory blood volume during abdominal aortic aneurysm repair. Prog Med. 2008;28:1259–64. (in Japanese).

Titel: The effects of the early administration of sivelestat sodium, a selective neutrophil elastase inhibitor, on the postoperative course after radical surgery for esophageal cancer
verfasst von: Junichi Nishiyama
Mitsumasa Matsuda
Satoko Ando
Miyoko Hirasawa
Toshiyasu Suzuki
Hiroyasu Makuuchi
Publikationsdatum: 01.07.2012
Verlag: Springer Japan
Erschienen in: Surgery Today / Ausgabe 7/2012
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-011-0105-5

Leitlinien kompakt für die Allgemeinmedizin

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Facharzt-Training Allgemeinmedizin

Die ideale Vorbereitung zur anstehenden Prüfung mit den ersten 24 von 100 klinischen Fallbeispielen verschiedener Themenfelder

Mehr erfahren

Neu im Fachgebiet Allgemeinmedizin

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Metformin rückt in den Hintergrund

24.04.2024 DGIM 2024 Kongressbericht

Es hat sich über Jahrzehnte klinisch bewährt. Doch wo harte Endpunkte zählen, ist Metformin als alleinige Erstlinientherapie nicht mehr zeitgemäß.

Myokarditis nach Infekt – Richtig schwierig wird es bei Profisportlern

24.04.2024 DGIM 2024 Kongressbericht

Unerkannte Herzmuskelentzündungen infolge einer Virusinfektion führen immer wieder dazu, dass junge, gesunde Menschen plötzlich beim Sport einen Herzstillstand bekommen. Gerade milde Herzbeteiligungen sind oft schwer zu diagnostizieren – speziell bei Leistungssportlern.

Update Allgemeinmedizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 7/2012

Primary squamous cell carcinoma in the gastric remnant

Current trends in TSH suppression therapy for patients with papillary thyroid carcinoma in Japan: results of a questionnaire distributed to councilors of the Japanese Society of Thyroid Surgery

Adult ileoileal intussusception induced by an ileal lipoma diagnosed preoperatively: report of a case and review of the literature

Quality of life after laparoscopy-assisted pylorus-preserving gastrectomy: an evaluation using a questionnaire mailed to the patients

The effects of the Kampo medicine (Japanese herbal medicine) “Daikenchuto” on the surgical inflammatory response following laparoscopic colorectal resection

Floating gallbladder strangulation caused by the lesser omentum: report of a case