Control of the Excessive Reaction after Surgery for Esophageal Carcinoma with Preoperative Administration of the Cortico-steroids.

Sayama, Junzo; Shineha, Ryuzaburo; Yokota, Kenichi; Hirayama, Kyosuke; Higuchi, Norio; Ohe, Hirofumi; Nakano, Tatsuya; Miyata, Gou; Sugawara, Kazunobu; Ueda, Harumasa; Nishihira, Tetsuro; Mori, Shiro

doi:10.5833/jjgs.27.841

Cited by 14 publications

(16 citation statements)

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“…Japanese authors have advocated perioperative steroid administration to reduce liver damage 11 by inhibiting membrane peroxidation (oxygen free radical cascade) and reducing cytokine release 19,20 . It has been shown that a single preoperative dose of methylprednisolone reduces postoperative production of IL-6 20,21 , an indicator of inflammatory status and the acute-phase response to surgery 4,7,22 . IL-6 usually peaks within 4-8 h after the surgical injury, decreasing in the next 48-72 h. The magnitude of the increase seems to be related to the extent of tissue injury 22 .…”

Section: Discussionmentioning

confidence: 99%

Prospective randomized study of steroids in the preventionof ischaemic injury during hepatic resection with pedicle clamping

Muratore

Ribero

Ferrero

et al. 2003

British Journal of Surgery

114

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Background:The major drawback of hepatic pedicle clamping is ischaemia-reperfusion injury with impairment of liver function. Perioperative steroid administration has been advocated to reduce liver damage. The aim of this prospective, randomized study was to determine whether steroid administration can reduce liver injury and improve short-term outcome.Methods: Fifty-three patients undergoing liver resection were randomized to a steroid group (group 1) or to a control group (group 2); patients in group 1 received methylprednisolone 30 mg/kg 30 min before liver resection whereas those in group 2 did not. Serum levels of interleukin (IL) 6, total bilirubin, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and prothrombin time (PT) were measured. Length of stay, and type and number of complications were recorded.Results: Serum IL-6 levels were significantly lower in the steroid group than in the control group 24 h after surgery. Steroid administration significantly modified AST, ALT and PT levels only in patients with chronic liver disease. Overall and lung-related morbidity were not significantly different between the two groups.Conclusions: Steroid administration suppresses serum IL-6 levels, but has no effect on shortterm outcome.

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Section: Discussionmentioning

confidence: 99%

Prospective randomized study of steroids in the preventionof ischaemic injury during hepatic resection with pedicle clamping

Muratore

Ribero

Ferrero

et al. 2003

British Journal of Surgery

114

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“…[4][5][6][7][8][9][10] After searching the references sections from these studies, one more study could be identified. 11 All were single center studies carried out in Japan. Seven articles were published in English and one article in Japanese 11 with the results, tables, and figures in English.…”

Section: Search Strategymentioning

confidence: 99%

Effect of Preoperative Single-Dose Corticosteroid Administration on Postoperative Morbidity Following Esophagectomy

Engelman

Maeyens

2010

Journal of Gastrointestinal Surgery

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“…The reason for adopting this regimen was based on previous literature, which reported that although steroids had no effect on serum cytokines already released, they did suppress the cytokine production of monocytes and macrophages [24,25]. In addition, a preoperative bolus administration of steroids was reported to reduce postoperative serum IL-6 levels and the incidence of peripheral leukocytopenia due to surgical stress [17,18,20,25]. Moreover, a short-term steroid pulse was reportedly better than a bolus steroid pulse [24].…”

Section: Discussionmentioning

confidence: 94%

“…Intravenous administration of 500 mg methylprednisolone has been confirmed to result in a methylprednisolone level of more than 1 µg/ml in blood or more than 10 µg/ml in liver tissue [25]. For thoracic esophageal surgery, preoperative administration of 250 mg/body or 10 mg/kg methylprednisolone has been reported to reduce production of inflammatory cytokines [17,18,22,25,26]. Therefore, we introduced perioperative steroid therapy of 250 mg/body methylprednisolone before surgery followed by 125 mg/body on postoperative days 1 and 2.…”

Section: Discussionmentioning

confidence: 97%

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Effect of steroid therapy on postoperative course and survival of patients with thoracic esophageal carcinoma

et al. 2004

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Background. Perioperative steroid therapy has been shown to be safe and effective in inhibiting the production of inflammatory mediators and reducing postoperative hospital morbidity. However, there is limited information to show the effect of steroid therapy on long-term survival. In this study we evaluated the effect of perioperative steroid therapy on long-term survival of patients with thoracic esophageal cancer. Methods. Between 1993 and 2000, 141 consecutive patients with primary thoracic esophageal cancer underwent radical esophagectomy. A total of 78 patients who underwent surgery between 1997 and 2000 received perioperative steroid therapy. Sixty-three patients who underwent surgery between 1993 and 1996 were analyzed as the control group. In the steroid group, 250 mg methylprednisolone was administered intravenously just before surgery followed by 125 mg on postoperative days 1 and 2. The postoperative course and overall cause-specific survival rates were compared between the groups. Results. The postoperative hospital morbidity rate was significantly lower in the steroid group than in the control group. Although overall survival of the steroid group was better than the control group, cause-specific survival of both groups was similar. Multivariate analysis suggested that the depth of tumor and postoperative hospital morbidity were significant independent prognostic factors; however, steroid therapy was not statistically significant after adjusting for pathological variables. Conclusions. Perioperative steroid therapy may improve the postoperative course but does not improve the longterm survival of patients with thoracic esophageal cancer.

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Control of the Excessive Reaction after Surgery for Esophageal Carcinoma with Preoperative Administration of the Cortico-steroids.

Cited by 14 publications

References 0 publications

Prospective randomized study of steroids in the preventionof ischaemic injury during hepatic resection with pedicle clamping

Prospective randomized study of steroids in the preventionof ischaemic injury during hepatic resection with pedicle clamping

Effect of Preoperative Single-Dose Corticosteroid Administration on Postoperative Morbidity Following Esophagectomy

Effect of steroid therapy on postoperative course and survival of patients with thoracic esophageal carcinoma

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