Effects and Clinical Significance of Two Bowel Preparation Methods for Colorectal Carcinoma Surgery on Preoperative Gut Mucosal Barrier Function_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XIE Shangkui ¹ , REN Donglin ¹ , WU Yinai ² , PENG Hui ¹ , KANG Liang ¹ , WANG Xiaoxue ¹ , SU Dan ¹

1.Department of Colorectal &;
Anal Surgery Ⅱ, The Sixth Affiliated Hospital (Gastrointestinal &;
Anal Hospital), Sun Yat-sen University, Guangzhou 510655, China;;
2.Department of General Surgery, The 157th Hospital of PLA, Guangzhou 510510, ChinaCorresponding Author: XIE Shang-kui, E-mail： xieskui@163.com;

Corresponding author：

Keywords：

Colorectal carcinoma; Gut preparation; Gut mucosal barrier

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Objective 　To investigate the effect and clinical significance of 3 d and 1 d bowel preparation method for colorectal carcinoma surgery on preoperative gut mucosal barrier function.
Methods 　Plasma levels of D-lactate (D-LAC), diamine oxidase (DAO) and endotoxin (ET) were measured at 2 h before operation in 3 d bowel preparation group (50 cases) and 1 d bowel preparation group (50 cases), 25 cases of inguinal hernia were included as control group. D-LAC, DAO and ET were detected by using enzymatic spectrophotometric assay, spectrophotometric assay and limulus lysate test with azo chromogenic substrate, respectively. Results 　Preoperative plasma levels of D-LAC, DAO and ET in 3 d bowel preparation group were (10.25±1.43) mg/L, (5.82±0.80) U/ml and (10.11±1.41) ng/L respectively. In 1 d bowel preparation group the corresponding values were (10.19±1.35) mg/L, (5.80±0.81) U/ml and (9.82±1.35) ng/L respectively. There were no significant differences between 3 d and 1 d bowel preparation group (P gt;0.05), compared with hernia group, 1 d and 3 d bowel preparation group were also no statistically significant differences (P gt;0.05).
Conclusions 　There are no significant preoperative gut mucosal barrier function damages in patients with 1 d and 3 d bowel preparation for colorectal carcinoma surgery, 1 d bowel preparation for colorectal carcinoma surgery can be performed in colorectal carcinoma patients, and 3 d bowel preparation can be used for certain special colorectal carcinoma patients.

Citation： XIE Shangkui,REN Donglin,WU Yinai,PENG Hui,KANG Liang,WANG Xiaoxue,SU Dan. Effects and Clinical Significance of Two Bowel Preparation Methods for Colorectal Carcinoma Surgery on Preoperative Gut Mucosal Barrier Function. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(9): 710-713. doi: Copy

1.	Zmora O, Pikarsky AJ, Wexner SD. Bowel preparation for colorectal surgery [Ｊ]. Dis Colon Rectum, 2001; 44（10）: 1537-1549.
2.	Fa-Si-Oen P, Roumen R, Buitenweg J, et al. Mechanical bowel preparation or not? Outcome of a multicenter, randomized trial in elective open colon surgery [Ｊ]. Dis Colon Rectum, 2005; 48（8）: 1509-1516.
3.	顾晋. 结直肠肿瘤外科医生观念的转变 [Ｊ]. 中国实用外科杂志, 2005; 25（10）: 585-587.
4.	毛一雷, 卢欣. 从肠粘膜屏障角度评价结直肠手术前肠道准备 [Ｊ]. 中国医学科学院学报, 2004; 26(5): 591-594.
5.	谢松, 孟荣贵, 于恩达，等. 选择性结直肠手术前三种肠道准备方案的对照研究 [Ｊ]. 中华普通外科杂志， 2002; 17（2）: 69-71.
6.	Smith SM, Eng RH, Campos JM, et al. D-lactic acid measurements in the diagnosis of bacterial infections [Ｊ]. J Clin Microbiol, 1989; 27(3): 385-388.
7.	Bragg LE, Thompson JS, West WW. Intestinal diamine oxidase levels reflect ischemic injury [Ｊ]. J Surg Res, 1991; 50(3): 228-233.
8.	Buttenschoen K, Berger D, Hiki N, et al. Plasma concentrations of endotoxin and antiendotoxin antibodies in patients with multiple injuries: a prospective clinical study [Ｊ]. Eur J Surg, 1996; 162(11): 853-860.
9.	Nichols RL, Smith JW, Garcia RY, et al. Current practices of preoperative bowel preparation among North American colorectal surgeons [Ｊ]. Clin Infect Dis, 1997； 24(4): 609-619.
10.	谢尚奎, 吴印爱, 刘献棠, 等. 直肠癌保肛术中行吻合口上下双管引流效果的观察 [Ｊ].中国普外基础与临床杂志, 2001; 8(1): 47-48.
11.	Oliveira L, Wexner SD, Daniel N, et al. Mechanical bowel preparation for elective colorectal surgery. A prospective, randomized, surgeon-blinded trial comparing sodium phosphate and polyethylene glycol-based oral lavage solutions [Ｊ]. Dis Colon Rectum, 1997; 40(5): 585-591.
12.	Zmora O, Mahajna A, Bar-Zakai B, et al. Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial [Ｊ]. Ann Surg, 2003; 237(3): 363-367.
13.	Jansen JO, O’Kelly TJ, Krukowski ZH, et al. Right hemicolectomy: mechanical bowel preparation is not required [Ｊ]. J R Coll Surg Edinb, 2002; 47(3): 557-560.
14.	Contant CM, Hop WC, van’t Sant HP, et al. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial [Ｊ]. Lancet, 2007; 370(9605): 2112-2117.
15.	Itani KM, Kim L. Mechanical bowel preparation or not for elective colorectal surgery [Ｊ]. Surg Infect (Larchmt), 2008; 9(6): 563-565.
16.	Guenaga KK, Matos D, Wille-Jrgensen P. Mechanical bowel preparation for elective colorectal surgery [Ｊ]. Cochrane Database Syst Rev, 2009; (1): CD001544.
17.	刘玉国, 栾丽娟. 恒康正清在结直肠癌术前肠道准备中的应用 [Ｊ]. 肿瘤基础与临床, 2006； 19(4): 326-327.
18.	谢松, 孟荣贵. 大肠疾病诊治的机械性肠道准备现状 [Ｊ]. 医学新知杂志, 2001; 11（2）: 86-87.
19.	卢欣, 毛一雷, 桑新亭, 等. 结直肠手术前磷酸钠盐一日肠道准备法临床观察 [Ｊ]. 中华外科杂志, 2006; 44（19）: 1327-1329.
20.	孙敬平, 马洪升. 应激状态下肠屏障功能的变化及其机理的研究进展 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(3): 314-316.
21.	余利坚, 徐亮, 姚晖, 等. 肠内免疫营养和生态营养对创伤后大鼠肠屏障功能的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 794-798.
22.	Griffiths EA, Duffy LC, Schanbacher FL, et al. In vivo ef-fects of bifidobacteria and lactoferrin on gut endotoxin concentration and mucosal immunity in Balb/c mice [Ｊ]. Dig Dis Sci, 2004; 49(4): 579-589.
23.	Li LJ, Wu ZW, Xiao DS, et al. Changes of gut flora and endotoxin in rats with D-galactosamine-induced acute liver failure [Ｊ]. World J Gastroenterol, 2004; 10(14): 2087-2090.
24.	吴仲文. 肠道屏障与肠道微生态 [Ｊ]. 中国危重病急救医学, 2004; 16(12): 768-770.
25.	吴国豪. 肠道屏障功能 [Ｊ]. 肠外与肠内营养, 2004; 11(1): 46-49.
26.	王峰, 赵瑛. D-乳酸与肠道屏障功能 [Ｊ]. 临床和实验医学杂志, 2006; 5(4): 423-424.
27.	夏阳, 秦环龙. 益生菌对大肠癌术后肠屏障功能及全身炎症反应的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 805-810.

1. Zmora O, Pikarsky AJ, Wexner SD. Bowel preparation for colorectal surgery [Ｊ]. Dis Colon Rectum, 2001; 44（10）: 1537-1549.
2. Fa-Si-Oen P, Roumen R, Buitenweg J, et al. Mechanical bowel preparation or not? Outcome of a multicenter, randomized trial in elective open colon surgery [Ｊ]. Dis Colon Rectum, 2005; 48（8）: 1509-1516.
3. 顾晋. 结直肠肿瘤外科医生观念的转变 [Ｊ]. 中国实用外科杂志, 2005; 25（10）: 585-587.
4. 毛一雷, 卢欣. 从肠粘膜屏障角度评价结直肠手术前肠道准备 [Ｊ]. 中国医学科学院学报, 2004; 26(5): 591-594.
5. 谢松, 孟荣贵, 于恩达，等. 选择性结直肠手术前三种肠道准备方案的对照研究 [Ｊ]. 中华普通外科杂志， 2002; 17（2）: 69-71.
6. Smith SM, Eng RH, Campos JM, et al. D-lactic acid measurements in the diagnosis of bacterial infections [Ｊ]. J Clin Microbiol, 1989; 27(3): 385-388.
7. Bragg LE, Thompson JS, West WW. Intestinal diamine oxidase levels reflect ischemic injury [Ｊ]. J Surg Res, 1991; 50(3): 228-233.
8. Buttenschoen K, Berger D, Hiki N, et al. Plasma concentrations of endotoxin and antiendotoxin antibodies in patients with multiple injuries: a prospective clinical study [Ｊ]. Eur J Surg, 1996; 162(11): 853-860.
9. Nichols RL, Smith JW, Garcia RY, et al. Current practices of preoperative bowel preparation among North American colorectal surgeons [Ｊ]. Clin Infect Dis, 1997； 24(4): 609-619.
10. 谢尚奎, 吴印爱, 刘献棠, 等. 直肠癌保肛术中行吻合口上下双管引流效果的观察 [Ｊ].中国普外基础与临床杂志, 2001; 8(1): 47-48.
11. Oliveira L, Wexner SD, Daniel N, et al. Mechanical bowel preparation for elective colorectal surgery. A prospective, randomized, surgeon-blinded trial comparing sodium phosphate and polyethylene glycol-based oral lavage solutions [Ｊ]. Dis Colon Rectum, 1997; 40(5): 585-591.
12. Zmora O, Mahajna A, Bar-Zakai B, et al. Colon and rectal surgery without mechanical bowel preparation: a randomized prospective trial [Ｊ]. Ann Surg, 2003; 237(3): 363-367.
13. Jansen JO, O’Kelly TJ, Krukowski ZH, et al. Right hemicolectomy: mechanical bowel preparation is not required [Ｊ]. J R Coll Surg Edinb, 2002; 47(3): 557-560.
14. Contant CM, Hop WC, van’t Sant HP, et al. Mechanical bowel preparation for elective colorectal surgery: a multicentre randomised trial [Ｊ]. Lancet, 2007; 370(9605): 2112-2117.
15. Itani KM, Kim L. Mechanical bowel preparation or not for elective colorectal surgery [Ｊ]. Surg Infect (Larchmt), 2008; 9(6): 563-565.
16. Guenaga KK, Matos D, Wille-Jrgensen P. Mechanical bowel preparation for elective colorectal surgery [Ｊ]. Cochrane Database Syst Rev, 2009; (1): CD001544.
17. 刘玉国, 栾丽娟. 恒康正清在结直肠癌术前肠道准备中的应用 [Ｊ]. 肿瘤基础与临床, 2006； 19(4): 326-327.
18. 谢松, 孟荣贵. 大肠疾病诊治的机械性肠道准备现状 [Ｊ]. 医学新知杂志, 2001; 11（2）: 86-87.
19. 卢欣, 毛一雷, 桑新亭, 等. 结直肠手术前磷酸钠盐一日肠道准备法临床观察 [Ｊ]. 中华外科杂志, 2006; 44（19）: 1327-1329.
20. 孙敬平, 马洪升. 应激状态下肠屏障功能的变化及其机理的研究进展 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(3): 314-316.
21. 余利坚, 徐亮, 姚晖, 等. 肠内免疫营养和生态营养对创伤后大鼠肠屏障功能的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 794-798.
22. Griffiths EA, Duffy LC, Schanbacher FL, et al. In vivo ef-fects of bifidobacteria and lactoferrin on gut endotoxin concentration and mucosal immunity in Balb/c mice [Ｊ]. Dig Dis Sci, 2004; 49(4): 579-589.
23. Li LJ, Wu ZW, Xiao DS, et al. Changes of gut flora and endotoxin in rats with D-galactosamine-induced acute liver failure [Ｊ]. World J Gastroenterol, 2004; 10(14): 2087-2090.
24. 吴仲文. 肠道屏障与肠道微生态 [Ｊ]. 中国危重病急救医学, 2004; 16(12): 768-770.
25. 吴国豪. 肠道屏障功能 [Ｊ]. 肠外与肠内营养, 2004; 11(1): 46-49.
26. 王峰, 赵瑛. D-乳酸与肠道屏障功能 [Ｊ]. 临床和实验医学杂志, 2006; 5(4): 423-424.
27. 夏阳, 秦环龙. 益生菌对大肠癌术后肠屏障功能及全身炎症反应的影响 [Ｊ]. 中国普外基础与临床杂志, 2008; 15(11): 805-810.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effects and Clinical Significance of Two Bowel Preparation Methods for Colorectal Carcinoma Surgery on Preoperative Gut Mucosal Barrier Function

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