Effect of Ulinastatin on the Postoperative Course in Patients with Carcinoma of the Esophagus

Masayuki Goto, Shingo Shima, Hajime Yonekawa, Yoshihisa Morisaki, Hiroyuki Wakiyama, Yutaka Yoshizumi, Susumu Tanaka

Department of Surgery II, National Defense Medical College

This study was designed to evaluate the effect of prophylactic administration of Ulinastatin which may protect important organs in patients with esophageal cancer from surgical damage. Thirty-seven patients were divided into two groups at random; 17 patients were given 100,000 units of Ulinastatin intravenously just before the operation, 200,000 U just after the operation and 300,000 U per day for the next four days. The other 20 patients were not given it. In order to determine the effectiveness of Ulinastatin, the following parameters were examined: granulocyte elastase, white blood cell count, lipid peroxide, fibronectin, complement, liver function, renal function and respiratory function. A significant increase in urine volume (p<0.05) and a significant decrease in respiratory index (p<0.01) on the first postoperative day were found in the Ulinastatin group as compared with the control group. No significant differences between the two groups in the other parameters were found. It may be considered that the surgical stress due to esophagectomy for esophageal cancer does not cause an excessive reaction of the host-defense mechanism with granulocytes, and that Ulinastatin increases urine volume and improves respiratory function in the early postoperative phase by a mechanism other than inhibition of neutral protease.

Key words
the surgical stress of esophageal cancer, Ulinastatin, granulocyte elastase, organ protection

Reprint requests
Masayuki Goto Department of Surgery II, National Defense Medical College
3-2 Namiki, Tokorozawa 359 JAPAN

Accepted
July 10, 1990

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