Influence of Corticosteriod Preoperative Administration for Surgical Stress of the Esophageal Cancer Patients during Peri-and Post-operative Periods

Abstract

Influence of Corticosteriod Preoperative Administration for Surgical Stress of the Esophageal Cancer Patients during Peri-and Post-operative Periods Shigeyuki Takemura, Kiichi Miya, Hiroshi Takao, Takao Umemoto and Shigetoyo Saji Second Department of Surgery, Gifu University, School of Medicine In terms of surgical stress during the peri-and postoperative periods, the influence of preoperative ad- ministration of methylpredonisolone (250mg/body) was investigated. Perticipants were esophageal cancer pa-tients divided into two groups: one group treated with steroid (S, n=9), and one group treated without ste-riod (C, n=9). The results showed that heart rate, body temperature, catecholamine dose and C-reactive pro-tein value were significantly lower in the S group than in the C group. Plasma levels of tumor necrosis factor-α, interleukin (IL)-1β, IL-6, IL-8were significantly decreased in the S group than in the C group. Although, the plasma level of IL-10showed significantly high value on day7after operation in the S group, and IL-12showed slightly high values in5cases in the C group on days3to7after operation. Evaluation by T lymphoid cell growth suppression assay showed that the host-immunosuppressive activity decreased slightly6to72hours after operation. Two cases in the S group showed minor signs of shock due to postoperative complications. The above results suggest that preoperative steroid administration can inhibit the hyperproduction of inflam-matory cytokines and reduce surgical stress, however host immuno-competency may decrease also3days af-ter surgery. Therefore, physicians should exercise coution in using this steroid in cases with residual cancer.