Efficacy of Intraoperative, Single-Bolus Corticosteroid Dose to Prevent Postoperative Respiratory Complication after Transhiatal Esophagectomy
محل انتشار: مجله پزشکی قلب و قفسه سینه، دوره: 6، شماره: 1
سال انتشار: 1397
نوع سند: مقاله ژورنالی
زبان: انگلیسی
مشاهده: 419
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شناسه ملی سند علمی:
JR_JCTM-6-1_001
تاریخ نمایه سازی: 18 تیر 1398
چکیده مقاله:
Introduction: Esophageal cancer is among the most common malignancies. Hospital mortality in the past decade reduced; but its morbidity is still high. Pulmonary complications are the most common complications after esophageal resection. In this study we examined the effect of steroids administration during surgery to reduce postoperative morbidity with a focus on respiratory complications.Material and Methods: Patients with esophageal cancer who underwent transhiatal esophagectomy, randomly divided into two groups to thirty patients: The intervention group (received 125mg methylprednisolone sodium succinate). After surgery, patients admitted in the ICU for a day. Oral feeding initiated on day 7th and patients discharged home on the day 8th or 9th.Postoperative complications included anastomotic fistula, wound infection in the neck and abdomen and pulmonary complications. We analyzed pulmonary complications included pneumonia, Acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) occurred before the seventh day. The leukocyte counts and CRP levels measured on the 2nd and 7th days after surgery.Results: 60 patients enrolled in the study. Incidence of ARDS, ALI and pneumonia in the control group was 3, 5 and 2 and in steroid group 1, 1 and 1 respectively. CRP levels and blood leukocyte count was similar in two groups on the second day but seventh day values and difference between the two levels between the second and seventh days were significantly different between the two groups (p<0.001).Conclusion: Intraoperative single dose corticosteroids are effective in preventing pulmonary complications after transhiatal esophagectomy. Methylprednisolone reduced the increase in CRP levels after surgery and decreased blood leukocyte count more in postoperative period.
کلیدواژه ها:
نویسندگان
Reza Afghani
Thoracic Surgeon, department of general surgery, ۵th of Azar Hospital, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Reza Bagheri
Thoracic Surgeon, Lung Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Seyed Ziaollah Haghi
Thoracic Surgeon, , Lung Disease Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
Seyed Hossein Fattahi Masoum
Thoracic Surgeon, Endoscopic and Minimally Invasive Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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