Effects of Neutrophil Elastase Inhibitor in Preventing Lung Injury after Esophagectomy for Esophageal Cancer

Abstract

We studied the usefulness of administering neutrophil elastase inhibitor following radical esophagectomy for cancer, examining interleukin-6 (IL-6), neutrophil elastase, C-reactive protein (CRP), and the PaO₂/FiO₂ (P/F) ratio, an indicator of respiratory dysfunction. The steroid-only (5) group included 11 patients, the steroid-plus-neutrophil elastase inhibitor (SE) group 11, and the untreated control (N) group 9. Clinicopathologic factors, operative time, and intraoperative blood loss did not differ between groups. The N group showed higher IL-6, neutrophil elastase, and CRP than other groups, while all groups showed similar changes in leukocyte count, aspartate aminotransferase, and alanine aminotransferase. The P/F ratio was higher in the SE group than in other groups from day 1 to 5 after surgery, with no difference between the N and S groups. Preoperative steroid administration thus controls cytokines and neutrophil elastase after esophagectomy for esophageal cancer, while concomitant administration of neutrophil elastase inhibitor may improve postoperative respiratory function.