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Intestinal permeability is increased after major vascular surgery
R M Roumen1, J A van der Vliet, R A Wevers
1Department of Surgery, University Hospital Nijmegen, The Netherlands.
Journal of Vascular Surgery
|April 1, 1993
Summary
Major vascular surgery significantly increases intestinal permeability in patients, regardless of whether the procedure is elective or emergency. This heightened permeability is primarily attributed to reperfusion injury, not prolonged ischemia.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Physiology
Background:
- Experimental studies show increased intestinal permeability after ischemia and reperfusion injury.
- Intestinal permeability is a crucial factor in post-surgical complications.
Purpose of the Study:
- To determine intestinal permeability in patients undergoing elective or emergency aortic aneurysm repair.
- To compare intestinal permeability between elective and emergency surgical groups, including those in shock.
Main Methods:
- Utilized a dual sugar absorption test with lactulose and mannitol as markers.
- Measured intestinal permeability 24-30 hours after hospital admission.
Main Results:
- Healthy controls had a lactulose/mannitol ratio of 0.012 +/- 0.005.
- Patients undergoing elective repair showed a ratio of 0.118 +/- 0.116.
- Patients undergoing emergency repair showed a ratio of 0.098 +/- 0.093.
- Both patient groups exhibited significantly increased intestinal permeability (p < 0.01) compared to controls.
- No significant difference in permeability was observed between elective and emergency groups.
Conclusions:
- Significant increases in intestinal permeability are common after major vascular surgery (elective and emergency).
- Reperfusion injury is suggested as the primary cause, rather than intestinal ischemia itself.