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Related Experiment Videos

Isotopic studies during surgical convalescence.

D A Humberstone1, J H Shaw

  • 1University Department of Surgery, Auckland Hospital, New Zealand.

The British Journal of Surgery
|February 1, 1989
PubMed
Summary

Post-surgery recovery significantly alters glucose metabolism, increasing glucose production and recycling while decreasing oxidation. Hormonal changes include higher insulin and cortisol levels, but protein metabolism and energy expenditure remain stable.

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Area of Science:

  • Metabolic Surgery
  • Endocrinology
  • Clinical Nutrition

Background:

  • Surgical recovery involves complex metabolic and hormonal adjustments.
  • Understanding these changes is crucial for optimizing patient care and recovery.
  • Previous studies have focused on specific aspects, but a comprehensive view of glucose and protein metabolism post-surgery is needed.

Purpose of the Study:

  • To investigate the impact of uncomplicated surgery on glucose and protein metabolism during convalescence.
  • To examine hormonal milieu changes, including insulin and cortisol levels, after surgery.
  • To assess resting energy expenditure in the postoperative period.

Main Methods:

  • Paired isotopic studies were conducted in patients undergoing colorectal cancer resection or parathyroid adenoma removal.

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  • Kinetic measurements of protein and glucose metabolism were performed pre-operatively and 10 weeks post-surgery.
  • Hormonal levels (insulin, cortisol) and resting energy expenditure were assessed.

    • Main Results:

    • Convalescence showed significant alterations in glucose metabolism, including doubled glucose production and increased glucose recycling to lactate.
    • A decrease in glucose oxidation and a relative hyperinsulinemia with reduced glucose load responsiveness were observed.
    • Serum cortisol levels were elevated, while protein kinetics and resting energy expenditure remained unchanged.

    Conclusions:

    • Uncomplicated surgery leads to marked increases in glucose production and recycling, with decreased glucose oxidation during convalescence.
    • Postoperative hormonal changes include relative hyperinsulinemia and elevated cortisol, impacting glucose regulation.
    • Protein metabolism and energy expenditure are not significantly affected in the convalescent period after uncomplicated surgery.