Published online Mar 28, 2015. doi: 10.3748/wjg.v21.i12.3720
Peer-review started: May 17, 2014
First decision: June 10, 2014
Revised: June 23, 2014
Accepted: July 29, 2014
Article in press: July 30, 2014
Published online: March 28, 2015
Core tip: Radical esophagectomy has been adopted in patients with esophageal carcinoma to improve survival. This technique is highly invasive, leading to excess surgical stress, a perioperative mortality of 3%-10%, and pulmonary disorders account for nearly 30%-60%. Sivelestat sodium hydrate, a specific neutrophil elastase inhibitor, actively protects patients with acute respiratory diseases. The efficacy and safety of sivelestat administered during esophagectomy has produced conflicting results and the conclusions from relevant studies are presented. This meta-analysis revealed that sivelestat is beneficial in patients undergoing esophagectomy, especially in terms of the duration of mechanical ventilation and the incidence of pulmonary complications.