RA02.06: PREVENTION OF ATRIAL FIBRILLATION AND POSTOPERATIVE COMPLICATIONS USING LANDIOLOL HYDROCHLORIDE AFTER ESOPHAGECTOMY FOR ESOPHAGEAL CANCER

Abstract

Abstract Background The aim of this study was to evaluate if landiolol hydrochloride is effective and safe in the prevention of atrial fibrillation (AF) after esophagectomy and that the reduction of AF incidence would reduce other postoperative complications. No prospective data exist regarding the efficacy of landiolol in preventing new-onset AF and translating low morbidity in esophageal cancer patients after esophagectomy. Methods One hundred patients scheduled for transthoracic esophagectomy were enrolled in a randomized, double-blind, placebo-controlled trial between March 2013 and January 2016 in our institute. Enrolled patients were randomized with 1:1 parallel allocation ratio to either with or without landiolol prophylaxis. The primary endpoint was the occurrence of AF after esophagectomy. The secondary endpoints were incidence of postoperative complications, hemodynamics and inflammatory index. Results Postoperative AF occurred in 15 patients (30%) in the placebo group versus five patients (10%) in the landiolol group. The landiolol group showed a significantly lower incidence (P = 0.012). Overall incidence of postoperative complications was significantly lower in the landiolol group (P = 0.046). In the landiolol group, postoperative heart rate was effectively suppressed, while the decreased of blood pressure was not harmful. IL-6 level was significantly lower in the landiolol group after the administration (P < 0.01). Conclusion This is the first comparative trial that proved landiolol is indeed effective and safe in preventing AF after esophagectomy. We recommend that landiolol to be a part of the regimen for perioperative management of esophageal cancer patients undergoing transthoracic esophagectomy. Registration number: UMIN000010648 (http://www.umin.ac.jp/ctr/) Disclosure All authors have declared no conflicts of interest.