Preventive effect of sivelestat on postoperative respiratory disorders after thoracic esophagectomy

Purpose Sivelestat, a selective inhibitor of neutrophil elastase, has been reported to reduce acute lung injury associated with systemic inflammatory response syndrome. This study retrospectively investigated the effect of sivelestat on respiratory function in patients who underwent esophagectomy. Methods Patients who underwent esophagectomy for thoracic esophageal cancer between 2005 and 2010 were included in this study. Forty-two were treated perioperatively with sivelestat (4.8 mg/kg/day; sivelestat group) and the remaining 35 were not (control group). Sivelestat was administered continuously from the beginning of surgery until postoperative day 3. All patients were administered methylprednisolone for 3 days. The perioperative clinical and laboratory data, total sequential organ failure assessment score, PaO 2 /FiO 2 ratio (P/F ratio) and postoperative complications were compared between the two groups. Results There were no significant differences between the groups in the patients’ background data. The P/F ratio immediately after surgery was significantly higher in the sivelestat group than in the control group ( p