Abstract
Background. Despite improvements in surgical techniques and perioperative care, severe complications
lead to long hospital stays for some esophageal cancer patients. The purpose of this
study was to evaluate the safety and effectiveness of perioperative steroid therapy
on the postoperative clinical course. Methods. Fifty-seven patients operated for esophageal cancer in 1997 and 1998 were treated
with perioperative steroid therapy. Fifty consecutive patients operated in 1995 and
1996 served as a control group. In the steroid group, each patient was given 250 mg
of methylprednisolone intravenously before operation followed by 125 mg on postoperative
days 1 and 2. Serum interleukin-6, polymorphonuclear cell elastase, and C-reactive
protein levels, and the postoperative clinical course were compared between the groups.
Results. Morbidity rates including hyperbilirubinemia, anastomotic leakage, and liver dysfunction
were significantly lower in the steroid group than in the control group. Days until
extubation and hospital stay were significantly shorter for the steroid group. Inflammatory
mediators, body temperature, heart rate, and respiratory index after the surgical
procedure were significantly lower in the steroid group. Adverse effects possibly
caused by steroid therapy were not observed. Conclusions. Perioperative steroid therapy was safe and effective for the inhibition of inflammatory
mediators and the improvement of the postoperative clinical course of patients with
esophageal cancer. (Surgery 2000;128:791-8.)
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Article info
Publication history
Accepted:
April 28,
2000
Footnotes
*Supported by a Grant-in-Aid from the Ministry of Health and Welfare of Japan and a Grant-in-Aid from the Ministry of Education, Science, and Culture of Japan.
**Reprint requests: Hideaki Shimada, MD, Department of Surgery, Chiba University School of Medicine, 1-8-1 Inohana, Chuou-ku, Chiba 260-8677, Japan.
★Surgery 2000;127:791-8.
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
