[The effect of corticosteroids on postoperative course after esophageal resection for carcinoma]

The effect of steroids against inflammatory mediators is well known, but its benefit and adverse effect on the postoperative clinical course are uncertain after esophageal resection for carcinoma.

Forty-three cases undergoing esophageal resection for carcinoma were studied retrospectively. Twenty-six cases, given corticosteroids during operation or first postoperative day, were classified as the steroid group, and the other 17 cases were defined as the control group. Postoperative courses, complications, and outcomes were compared between these 2 groups.

In the steroid group, heart rate, body temperature and C-response protein were depressed during the postoperative period, and duration of systemic inflammatory response syndrome was 1.2 +/- 1.1 days compared with 2.7 +/- 1.4 days in the control group (P < 0.001). Although the duration of mechanical ventilation and ICU stay was unchanged, morbidity rate of postoperative anastomotic leakage was 15% in the steroid group compared with 47% in the control group (P < 0.05). The other morbidity rates of pulmonary complications, postoperative infection, arrhythmia, and liver dysfunction as well as mortality rate were similar between the 2 groups.

Corticosteroids given in the early postoperative period depress systemic inflammatory response and attenuate the rate of postoperative anastomotic leakage after esophageal resection for carcinoma.