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Related Experiment Videos

Glucocorticoid attenuates a decrease of antithrombin III following major surgery

T Matsutani1, M Onda, K Sasajima

  • 1First Department of Surgery, Nippon Medical School, 1-1-5 Sendagi, Tokyo, Bunkyo-ku, 113, Japan.

The Journal of Surgical Research
|October 6, 1998
PubMed
Summary

Preoperative methylprednisolone effectively reduced inflammation and protected antithrombin-III (AT-III) levels after esophagectomy. This suggests glucocorticoids may mitigate surgical stress by lowering interleukin-6 (IL-6) production.

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Area of Science:

  • Surgical Oncology
  • Anesthesiology
  • Immunology

Background:

  • Major surgery like esophagectomy triggers inflammatory responses and coagulation system activation.
  • This activation involves releasing inflammatory cytokines and decreasing antithrombin-III (AT-III).
  • Preoperative glucocorticoids may reduce post-surgical cytokine levels.

Purpose of the Study:

  • To investigate the effect of methylprednisolone on inflammatory markers and coagulation factors following esophagectomy.
  • To determine if methylprednisolone can attenuate the inflammatory and coagulation changes associated with major surgery.

Main Methods:

  • A randomized controlled trial involving 28 patients undergoing esophagectomy for esophageal carcinoma.
  • 14 patients received methylprednisolone, while 14 served as controls.

Related Experiment Videos

  • Measurement of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), AT-III, and albumin levels pre- and post-operatively.

    • Main Results:

    • Esophagectomy increased TNF-alpha, IL-6, and thrombin-antithrombin III complex (TAT) levels in both groups.
    • Methylprednisolone inhibited increases in TNF-alpha and IL-6 and prevented decreases in AT-III and albumin.
    • Methylprednisolone did not affect polymorphonuclear (PMN) elastase or TAT levels.

    Conclusions:

    • Preoperative methylprednisolone attenuates the decrease in AT-III levels post-esophagectomy.
    • This protective effect appears to be mediated by reduced interleukin-6 (IL-6) production.
    • Methylprednisolone demonstrates potential in managing inflammatory responses after major surgery.