間質性肺炎合併肺癌の術後急性増悪予防の試み

A Trial of the Prevention of Postoperative Acute Exacerbation of Interstitial Pneumonia in Patients with Lung Cancer

間質性肺炎（IP）合併肺癌の手術において，術後急性増悪（AE）は非常に重要な問題であり，呼吸器外科領域のもっとも大きな課題の一つである．われわれは，IP合併肺癌の手術において，周術期のステロイドおよびerythromycin（EM）投与と術中からのsivelestat sodium投与のAE予防の効果について検討を行ったので報告する．

On preventing postoperative acute exacerbation （AE） of interstitial pneumonia （IP） in patients with lung cancer, the effect of administration of sivelestat sodium, steroids and erythromycin （EM） was assessed in 24 patients who was diagnosed as having IP and underwent surgery between April 2007 and October 2016. Oral administration of EM （400 mg） was started one week before the surgery, and methylprednisolone （125 mg） was administered intravenously at the time of anesthesia induction, postoperative day 1 and 2. Sivelestat sodium was administered intravenously at 4.8 mg/kg/day during the surgery, which was continued for 3-5 days. AEs occurred in two cases （8.3％）. One patient developed AEs on postoperative day 5 and died in the hospital on postoperative day 76. The other patient developed AEs on postoperative day 38 and died in the hospital on postoperative day 43. In addition to the perioperative administration of steroids and EM in patients with lung cancer and IP, intraoperative administration of sivelestat sodium was suggested to be safe and to potentially prevent AEs.