Influence of Corticosteriod Preoperative Administration for Surgical Stress of the Esophageal Cancer Patients during Peri-and Post-operative Periods

Shigeyuki Takemura, Kiichi Miya, Hiroshi Takao, Takao Umemoto and Shigetoyo Saji

Second Department of Surgery, Gifu University, School of Medicine

In terms of surgical stress during the peri-and postoperative periods, the influence of preoperative administration of methylpredonisolone (250 mg/body) was investigated. Perticipants were esophageal cancer patients divided into two groups: one group treated with steroid (S, n=9), and one group treated without steriod (C, n=9). The results showed that heart rate, body temperature, catecholamine dose and C-reactive protein value were significantly lower in the S group than in the C group. Plasma levels of tumor necrosis factor-α , interleukin (IL) -1β, IL-6, IL-8 were significantly decreased in the S group than in the C group. Although, the plasma level of IL-10 showed significantly high value on day 7 after operation in the S group, and IL-12 showed slightly high values in 5 cases in the C group on days 3 to 7 after operation. Evaluation by T lymphoid cell growth suppression assay showed that the host-immunosuppressive activity decreased slightly 6 to 72 hours after operation. Two cases in the S group showed minor signs of shock due to postoperative complications. The above results suggest that preoperative steroid administration can inhibit the hyperproduction of inflammatory cytokines and reduce surgical stress, however host immuno-competency may decrease also 3 days after surgery. Therefore, physicians should exercise coution in using this steroid in cases with residual cancer.

Key words
esophageal cancer, preoperative administration of steroid hormone, inflammatory cytokines, surgical stress, T-cell growth supptession assay

Reprint requests
Shigeyuki Takemura Second Department of Surgery, Gifu University, School of Medicine 40 Tsukasamachi, Gifu, 500-8705 JAPAN

Accepted
January 27, 1999

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