[Postaggression metabolism following laparotomy and thoracotomy].

Area of Science:

• Metabolic Surgery
• Perioperative Medicine
• Clinical Biochemistry

Context:

• Surgical procedures, including thoracotomies and laparotomies, induce significant physiological stress.
• Understanding metabolic alterations during the perioperative phase is crucial for patient management.

Purpose:

• To investigate perioperative changes in carbohydrate and amino acid metabolism following major abdominal and thoracic surgeries.
• To compare metabolic responses across different surgical interventions like lobectomies, pneumonectomies, and colon resections.

Summary:

• Blood samples from 20 healthy adults were analyzed preoperatively and up to 4 days postoperatively.
• Significant increases in blood glucose, plasma cortisol, and free fatty acids were observed.
• Decreases in plasma albumin, pre-albumin, and specific amino acids (ALA, GLN, THR, PRO) were noted, with no significant changes in lactate, insulin, or branched-chain amino acids.

Impact:

• Major surgery induces a nonspecific stress response characterized by elevated lipolysis and gluconeogenesis, impaired glucose utilization, and peripheral insulin resistance.
• The observed metabolic profile shares similarities with the metabolic state seen in type 2 diabetes mellitus.
• Findings highlight the complex metabolic adaptations to surgical stress and their implications for clinical care.