Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy

K. Suda, Yuukou Kitagawa, S. Ozawa, T. Miyasho, M. Okamoto, Y. Saikawa, M. Ueda, S. Yamada, S. Tasaka, Y. Funakoshi, S. Hashimoto, H. Yokota, I. Maruyama, A. Ishizaka, M. Kitajima

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Sivelestat sodium hydrate is a selective inhibitor of neutrophil elastase (NE), and is effective in acute lung injury associated with systemic inflammatory response syndrome (SIRS). The effect of Sivelestat for postoperative clinical courses after transthoracic esophagectomy was investigated. Consecutive patients with carcinoma of the thoracic esophagus who underwent transthoracic esophagectomy between 2003 and 2004 were assigned to the Sivelestat-treated group (n = 18), and those between 1998 and 2003 were assigned to the control group (n = 25). The morbidity rate, duration of postoperative SIRS, mechanical ventilation, and intensive care unit (ICU) stay, and the sum of the sequential organ failure assessment scores at all time points after the operation were compared. Serum NE activities and serum concentrations of TNF-α, IL-1β IL-6, and high mobility group box chromosomal protein 1 (HMGB1) were measured. Postoperative complications developed in three patients in the control group, and one in the Sivelestat-treated group. The durations of SIRS, mechanical ventilation, and ICU stay were significantly shorter in the Sivelestat-treated group. Even in patients without complications, the durations of mechanical ventilation, and ICU stay were also significantly shorter, and the arterial oxygen pressure/fraction of inspired oxygen ratio at postoperative day 1 was significantly higher in the Sivelestat-treated group. Serum NE activities and serum concentrations of IL-1β, IL-6, and HMGB1 were significantly suppressed in the Sivelestat-treated group. Postoperative Sivelestat treatment after transthoracic esophagectomy improves the condition of SIRS and postoperative clinical courses, even in patients without complications.

Original languageEnglish
Pages (from-to)478-486
Number of pages9
JournalDiseases of the Esophagus
Volume20
Issue number6
DOIs
Publication statusPublished - 2007 Dec

Fingerprint

Secretory Proteinase Inhibitory Proteins
Esophagectomy
Thorax
Systemic Inflammatory Response Syndrome
Artificial Respiration
High Mobility Group Proteins
HMGB1 Protein
Intensive Care Units
Leukocyte Elastase
Serum
Interleukin-1
Interleukin-6
Organ Dysfunction Scores
Oxygen
Control Groups
sivelestat
Acute Lung Injury
Esophagus
Arterial Pressure
Sodium

Keywords

  • Acute respiratory distress syndrome
  • Complications
  • Esophageal cancer
  • Esophageal surgery
  • Inflammatory mediators
  • Surgery

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy. / Suda, K.; Kitagawa, Yuukou; 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.

In: Diseases of the Esophagus, Vol. 20, No. 6, 12.2007, p. 478-486.

Research output: Contribution to journalArticle

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 2007, 'Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy', Diseases of the Esophagus, vol. 20, no. 6, pp. 478-486. https://doi.org/10.1111/j.1442-2050.2007.00699.x
Suda, K. ; Kitagawa, Yuukou ; 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. In: Diseases of the Esophagus. 2007 ; Vol. 20, No. 6. pp. 478-486.
@article{c47ada5a64a046cfa12bd989be846fe5,
title = "Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy",
abstract = "Sivelestat sodium hydrate is a selective inhibitor of neutrophil elastase (NE), and is effective in acute lung injury associated with systemic inflammatory response syndrome (SIRS). The effect of Sivelestat for postoperative clinical courses after transthoracic esophagectomy was investigated. Consecutive patients with carcinoma of the thoracic esophagus who underwent transthoracic esophagectomy between 2003 and 2004 were assigned to the Sivelestat-treated group (n = 18), and those between 1998 and 2003 were assigned to the control group (n = 25). The morbidity rate, duration of postoperative SIRS, mechanical ventilation, and intensive care unit (ICU) stay, and the sum of the sequential organ failure assessment scores at all time points after the operation were compared. Serum NE activities and serum concentrations of TNF-α, IL-1β IL-6, and high mobility group box chromosomal protein 1 (HMGB1) were measured. Postoperative complications developed in three patients in the control group, and one in the Sivelestat-treated group. The durations of SIRS, mechanical ventilation, and ICU stay were significantly shorter in the Sivelestat-treated group. Even in patients without complications, the durations of mechanical ventilation, and ICU stay were also significantly shorter, and the arterial oxygen pressure/fraction of inspired oxygen ratio at postoperative day 1 was significantly higher in the Sivelestat-treated group. Serum NE activities and serum concentrations of IL-1β, IL-6, and HMGB1 were significantly suppressed in the Sivelestat-treated group. Postoperative Sivelestat treatment after transthoracic esophagectomy improves the condition of SIRS and postoperative clinical courses, even in patients without complications.",
keywords = "Acute respiratory distress syndrome, Complications, Esophageal cancer, Esophageal surgery, Inflammatory mediators, Surgery",
author = "K. Suda and Yuukou Kitagawa and S. Ozawa and T. Miyasho and M. Okamoto and Y. Saikawa and M. Ueda and S. Yamada and S. Tasaka and Y. Funakoshi and S. Hashimoto and H. Yokota and I. Maruyama and A. Ishizaka and M. Kitajima",
year = "2007",
month = "12",
doi = "10.1111/j.1442-2050.2007.00699.x",
language = "English",
volume = "20",
pages = "478--486",
journal = "Diseases of the Esophagus",
issn = "1120-8694",
publisher = "Wiley-Blackwell",
number = "6",

}

TY - JOUR

T1 - Neutrophil elastase inhibitor improves postoperative clinical courses after thoracic esophagectomy

AU - Suda, K.

AU - Kitagawa, Yuukou

AU - Ozawa, S.

AU - Miyasho, T.

AU - Okamoto, M.

AU - Saikawa, Y.

AU - Ueda, M.

AU - Yamada, S.

AU - Tasaka, S.

AU - Funakoshi, Y.

AU - Hashimoto, S.

AU - Yokota, H.

AU - Maruyama, I.

AU - Ishizaka, A.

AU - Kitajima, M.

PY - 2007/12

Y1 - 2007/12

N2 - Sivelestat sodium hydrate is a selective inhibitor of neutrophil elastase (NE), and is effective in acute lung injury associated with systemic inflammatory response syndrome (SIRS). The effect of Sivelestat for postoperative clinical courses after transthoracic esophagectomy was investigated. Consecutive patients with carcinoma of the thoracic esophagus who underwent transthoracic esophagectomy between 2003 and 2004 were assigned to the Sivelestat-treated group (n = 18), and those between 1998 and 2003 were assigned to the control group (n = 25). The morbidity rate, duration of postoperative SIRS, mechanical ventilation, and intensive care unit (ICU) stay, and the sum of the sequential organ failure assessment scores at all time points after the operation were compared. Serum NE activities and serum concentrations of TNF-α, IL-1β IL-6, and high mobility group box chromosomal protein 1 (HMGB1) were measured. Postoperative complications developed in three patients in the control group, and one in the Sivelestat-treated group. The durations of SIRS, mechanical ventilation, and ICU stay were significantly shorter in the Sivelestat-treated group. Even in patients without complications, the durations of mechanical ventilation, and ICU stay were also significantly shorter, and the arterial oxygen pressure/fraction of inspired oxygen ratio at postoperative day 1 was significantly higher in the Sivelestat-treated group. Serum NE activities and serum concentrations of IL-1β, IL-6, and HMGB1 were significantly suppressed in the Sivelestat-treated group. Postoperative Sivelestat treatment after transthoracic esophagectomy improves the condition of SIRS and postoperative clinical courses, even in patients without complications.

AB - Sivelestat sodium hydrate is a selective inhibitor of neutrophil elastase (NE), and is effective in acute lung injury associated with systemic inflammatory response syndrome (SIRS). The effect of Sivelestat for postoperative clinical courses after transthoracic esophagectomy was investigated. Consecutive patients with carcinoma of the thoracic esophagus who underwent transthoracic esophagectomy between 2003 and 2004 were assigned to the Sivelestat-treated group (n = 18), and those between 1998 and 2003 were assigned to the control group (n = 25). The morbidity rate, duration of postoperative SIRS, mechanical ventilation, and intensive care unit (ICU) stay, and the sum of the sequential organ failure assessment scores at all time points after the operation were compared. Serum NE activities and serum concentrations of TNF-α, IL-1β IL-6, and high mobility group box chromosomal protein 1 (HMGB1) were measured. Postoperative complications developed in three patients in the control group, and one in the Sivelestat-treated group. The durations of SIRS, mechanical ventilation, and ICU stay were significantly shorter in the Sivelestat-treated group. Even in patients without complications, the durations of mechanical ventilation, and ICU stay were also significantly shorter, and the arterial oxygen pressure/fraction of inspired oxygen ratio at postoperative day 1 was significantly higher in the Sivelestat-treated group. Serum NE activities and serum concentrations of IL-1β, IL-6, and HMGB1 were significantly suppressed in the Sivelestat-treated group. Postoperative Sivelestat treatment after transthoracic esophagectomy improves the condition of SIRS and postoperative clinical courses, even in patients without complications.

KW - Acute respiratory distress syndrome

KW - Complications

KW - Esophageal cancer

KW - Esophageal surgery

KW - Inflammatory mediators

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=35448947324&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=35448947324&partnerID=8YFLogxK

U2 - 10.1111/j.1442-2050.2007.00699.x

DO - 10.1111/j.1442-2050.2007.00699.x

M3 - Article

VL - 20

SP - 478

EP - 486

JO - Diseases of the Esophagus

JF - Diseases of the Esophagus

SN - 1120-8694

IS - 6

ER -