Does the Addition of Glutamine to Total Parenteral Nutrition Have Beneficial Effect on the Healing of Colon Anastomosis and Bacterial Translocation after Preoperative Radiotherapy?
Abstracts
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Background: Glutamine administration stimulates mucosal growth and preserves the morphology of the intestine. Therefore, it could improve colonic anastomotic healing after radiotherapy (RT) induced epithelial damage and mucosal atrophy induced by total parenteral nutrition (TPN). We investigated this issue in a rat model. Methods: The rectosigmoid colon in male Wistar rats was irradiated to a total dose of 25 Gy (5 Gy daily for 5 consecutive days). Five days after the end of RT, side-to-side anastomosis was performed between the irradiated rectosigmoid and the non-irradiated caecum. Postoperatively, animals were divided randomly into 3 groups; group I was fed orally (lab chow), group II received TPN and group III received TPN enriched with 2% glutamine (Gln-TPN). One week after surgery animals were sacrificed. Results: All animals decreased in weight during RT and after surgery. Weight regain postoperatively was better in the orally fed animals in comparison to the parenterally fed animals (I versus II & III; p<0.01). Colonic anastomotic bursting pressure (BP) and bursting wall tension (BWT) were significantly less in group II in comparison to group I and group III ( II versus I & III; p<0.01). BP and BWT were comparable in the animals that received Gln-TPN (group III) and the orally fed animals (group I). No significant differences were found between all the groups in gut bacterial translocation to the blood or to the mesenterical lymph nodes. Conclusion: Glutamine-enriched TPN counteracts the negative effect of food deprivation on colonic anastomotic healing. Postoperative Gln-TPN does not influence gut bacterial translocation in this rat model. |
