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  • Title: Is preoperative methylprednisolone beneficial for patients undergoing esophagectomy?
    Author: Yano M, Taniguchi M, Tsujinaka T, Fujiwara Y, Yasuda T, Shiozaki H, Monden M.
    Journal: Hepatogastroenterology; 2005; 52(62):481-5. PubMed ID: 15816462.
    Abstract:
    BACKGROUND/AIMS: This study examined whether or not preoperative administration of methylprednisolone reduces perioperative systemic inflammatory response and thus can offer clinical benefit to patients. METHODOLOGY: Forty patients with thoracic esophageal cancer who were scheduled for esophagectomy with lymphadenectomy were randomly allocated to either of the following two groups: 20 patients received methylprednisolone (500 mg/body) in saline 2 hours before surgery and another 20 patients received a placebo (saline alone). The effects on the early clinical course were assessed by rectal intramucosal pH (pHi) as a marker of systemic oxygenation, water balance, serum cytokine levels and the incidence of postoperative complications. The effects on the late clinical course were examined by comparing patient survival time. RESULTS: Rectal pHi value, water balance, blood balance and body weight change did not significantly differ between the two groups. Serum proinflammatory cytokine (interleukin-6 and interleukin-8) levels were significantly higher in the control group than the methylprednisolone group 2 hours after surgery. Serum C-reactive protein was also significantly higher in the control group on postoperative day 2 and 3. No significant differences were seen in the incidence of postoperative complications. Survival curves for the two groups did not statistically differ. CONCLUSIONS: Preoperative methylprednisolone significantly reduces inflammatory cytokine response immediately after surgery for esophageal cancer, but its clinical benefit remains unclear.
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