Perioperative prostaglandin E1 treatment for the prevention of postoperative complications after esophagectomy: a randomized clinical trial.

Abstract

PURPOSE:

We conducted a prospective randomized clinical study to examine whether perioperative prostaglandin E1 (PGE1) could help in the prevention of postoperative complications after esophagectomy for esophageal cancer.

METHODS:

Forty patients with esophageal cancer eligible for radical esophagectomy were randomly assigned to an experimental group ( n = 20), given perioperative PGE1, or to a control group ( n = 20), given standard postoperative treatment. The main clinical endpoints examined were the incidence of postoperative complications, hospitalization, duration of systemic inflammatory response syndrome (SIRS), portal vein blood flow, and serum bilirubin levels.

RESULTS:

Severe postoperative complications developed in five patients in the control group and two in the PGE1 group. There was one surgery-related death in the control group. The duration of SIRS was significantly shorter in the PGE1 group than in the control group (5.74 days vs 7.50 days; P = 0.047). Portal vein flow was also significantly lower on postoperative day (POD) 1 in the control group than in the PGE1 group ( P = 0.042). Maximum postoperative serum bilirubin levels were significantly lower in patients treated with PGE1, at 2.91 vs 4.38 mg/dl in the control group ( P = 0.040).

CONCLUSIONS:

The perioperative administration of PGE1 helps maintain adequate portal blood flow, improves hyperbilirubinemia, and attenuates the duration of SIRS, thereby reducing the risk of postoperative complications after esophagectomy and lymphadenectomy for esophageal cancer.

• Authors: Kazushige Oda, Seiji Akiyama, Katsuki Ito, Yasusi Kasai, Michitaka Fujiwara, Hiroyuki Sekiguchi, Akimasa Nakao, Junichi Sakamoto
• Journal: Surgery today (Surg Today) Vol. 34 Issue 8 Pg. 662-7 ( 2004) ISSN: 0941-1291 [Print] Japan
• PMID: 15290395 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial)

Chemical References

• Vasodilator Agents
• Alprostadil
• Bilirubin

Topics

• Adult
• Aged
• Alprostadil (therapeutic use)
• Bilirubin (blood)
• Carcinoma, Squamous Cell (surgery)
• Esophageal Neoplasms (surgery)
• Esophagectomy
• Female
• Humans
• Incidence
• Length of Stay (statistics & numerical data)
• Lymph Node Excision
• Male
• Middle Aged
• Portal Vein (diagnostic imaging)
• Postoperative Complications (epidemiology, prevention & control)
• Prospective Studies
• Systemic Inflammatory Response Syndrome (prevention & control)
• Ultrasonography
• Vasodilator Agents (therapeutic use)