Differences in gut integrity following abdominal surgery according to the magnitude of the surgical stress.
BACKGROUND
An increase in serum diamine oxidase (DAO) activity reflects intestinal mucosal damage. This was used to estimate the effect of surgical stress after elective abdominal surgery on gut integrity.


METHODS
Patients with gastrointestinal tract cancers were placed in either group T (transthoracic esophagectomy for esophageal cancer, n = 9) or group L (laparotomy, n = 10). The serum DAO activity was measured pre-operatively, and on postoperative days 1, 3, and 8.


RESULTS
Transthoracic esophagectomy was associated with a more extensive stress than the operations in group L, as measured by the intra-operative blood loss, the amount of blood transfused, and the operative time (P = 0.007, P = 0.0002, P = 0.0011, respectively). Following surgery, the serum DAO activity was decreased markedly in all patients in group T. In contrast, the activity was unchanged in group L (P = 0.04).


CONCLUSIONS
The severity of the surgical insult plays a significant role in the decrease in serum DAO activity. These results suggest that surgical stress influences gut integrity following elective abdominal surgery.
Sato
N
N
Department of Surgery, Niigata University School of Medicine, Japan. nobus@med.niigata-u.ac.jp
Oyamatsu
M
M
Koyama
Y
Y
Tamiya
Y
Y
Hatakeyama
K
K
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D006631:Amine Oxidase (Copper-Containing) / Q000097:blood*; D016063:Blood Loss, Surgical; D017558:Elective Surgical Procedures; D016629:Esophagectomy; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000503:physiopathology*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013312:Stress, Physiological / Q000503:physiopathology*
D006631:Amine Oxidase (Copper-Containing)