title: The role of lactulose in the prevention of bacterial translocation in surgical trauma.
abstract: Surgical trauma (ST) is one of the causative factor of bacterial translocation. In this study we investigated the prevention of bacterial translocation with lactulose in a surgical trauma model. The study was designed in 3 experimental groups consisting of 15 rats in each. Group 1 was sham operated controls, group 2 was ST + physiologic saline treated and group 3 was ST + lactulose treated animals. Lactulose and physiologic saline were given by oro-gastric intubation in a dose of 2 ml of 33.5% solution/d and 2 ml/d respectively starting 3 days prior to surgery. Bacterial translocation was investigated 48 hours after the operations. In sham operated controls only 1 bacterial translocation to the mesenteric lymph nodes (MLN) was observed. In the ST + physiologic saline treated group bacterial translocation to the MLN and portal venous blood (PVB) were significantly increased compared with both sham operated controls and the ST + lactulose treated group (p < 0.001). In rats with lactulose treatment the results of caecal bacterial counts showed a significant decrease in the number of gram-negative aerobes and facultative anaerobe bacteria (p < 0.01) and a significant increase in the number of lactobacilli (p < 0.001) compared to the sham operated controls. Measurement of the mucosal height showed a significant increase at the terminal ileum and the caecum compared with the sham operated controls and the surgical trauma+physiologic saline treated group (p < 0.001). We conclude that oral lactulose treatment 3 days prior to the surgical trauma, reduced the incidence of bacterial translocation to the MLN and PVB.
authors.affiliation: Department of General Surgery, Cerrahpaşa Medical Faculty, University of Istanbul, Turkey.
authors.forename: M F
authors.initials: MF
authors.lastname: Ozçelik
authors.forename: C
authors.initials: C
authors.lastname: Eroğlu
authors.forename: S
authors.initials: S
authors.lastname: Pekmezci
authors.forename: R
authors.initials: R
authors.lastname: Oztürk
authors.forename: M
authors.initials: M
authors.lastname: Paksoy
authors.forename: M
authors.initials: M
authors.lastname: Negizade
authors.forename: M
authors.initials: M
authors.lastname: Vardar
mesh_terms: D000818:Animals; D001420:Bacteria, Aerobic / Q000302:isolation & purification; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D018988:Bacterial Translocation / Q000187:drug effects*; D005243:Feces / Q000382:microbiology; D007413:Intestinal Mucosa / Q000382:microbiology; D007792:Lactulose / Q000494:pharmacology* / Q000627:therapeutic use; D007813:Laparotomy; D008198:Lymph Nodes / Q000382:microbiology; D008643:Mesentery; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D007792:Lactulose