pectins and Postoperative-Complications

One hundred and fifty patients aged 19 to 86 years with general peritonitis mainly in a toxic (85.3%) stage were examined. The leading causes of peritonitis were acute appendicitis (24.0%) and perforation of gastroduodenal ulcers (21.3%). Three groups of patients were formed with a pair samples method for a comparative analysis of treatment. The control group of patients was treated conventionally. Entero-sorption was performed through naso-intestinal tube with well-known carbonic sorbent UAO-A and pectin-containing medication made of red beet. The results were compared. A 1.3-fold decrease in entero-paresis naso-intestinal intubation duration, a relief in severity of the patients' condition by SAPS scale as early as on day 2, improvement of immunity indices, faster reduction of toxicity of blood plasma and leukocytic index of intoxication, a 12% decrease in postoperative pneumonia morbidity and postoperative lethality from 14 to 6.6% demonstrated advantages of entero-sorption with pectin-containing medication.

Topics: Acute Disease; Adult; Aged; Aged, 80 and over; Appendicitis; Enterosorption; Follow-Up Studies; Humans; Middle Aged; Pectins; Peptic Ulcer Perforation; Peritonitis; Postoperative Complications; Time Factors

Traumatic pulmonary injuries are common in chest trauma. Persistent air leaks occur in up to 46% of patients depending on injury severity. Prolonged leaks are associated with increased morbidity and cost. Prior work from our first-generation pectin patches successfully sealed pulmonary leaks in a cadaveric swine model. We now test the next-generation pectin patch against wedge resection in the management of air leaks in anesthetized swine.. A continuous air leak of 10% to 20% percent was created to the anterior surface of the lung in intubated and sedated swine. Animals were treated with a two-ply pectin patch or stapled wedge resection (SW). Tidal volumes (TVs) were recorded preinjury and postinjury. Following repair, TVs were recorded, a chest tube was placed, and animals were observed for presence air leak at closure and for an additional 90 minutes while on positive pressure ventilation. Mann-Whitney U test and Fisher's exact test used to compare continuous and categorical data between groups.. Thirty-one animals underwent either SW (15) or pectin patch repair (PPR, 16). Baseline characteristics were similar between animals excepting baseline TV (SW, 10.3 mL/kg vs. PPR, 10.9 mL/kg; p = 0.03). There was no difference between groups for severity of injury based on percent of TV loss (SW, 15% vs. PPR, 14%; p = 0.5). There was no difference in TV between groups following repair (SW, 10.2 mL/kg vs. PPR, 10.2 mL/kg; p = 1) or at the end of observation (SW, 9.8 mL/kg vs. PPR, 10.2 mL/kg; p = 0.4). One-chamber intermittent air leaks were observed in three of the PPR animals, versus one in the SW group ( p = 0.6).. Pectin patches effectively sealed the lung following injury and were noninferior when compared with wedge resection for the management of acute traumatic air leaks. Pectin patches may offer a parenchymal sparing option for managing such injuries, although studies evaluating biodurability are needed.

Topics: Animals; Chest Tubes; Humans; Lung; Lung Injury; Pectins; Pneumonectomy; Postoperative Complications; Swine

One of the primary causes of morbidity and mortality in those with short bowel syndrome (SBS) is sepsis, caused by bacterial translocation (BT). Since synbiotics can cease gut-related bacterial overgrowth, they may serve as a supportive dietary supplement-based strategy after gastrointestinal surgery. This study was conducted to determine the effects of Lactobacillus acidophilus and pectin on BT and gut adaptation after extensive small bowel resection in the rat. Forty rats were distributed in four groups. Group A suffered laparotomy, group B suffered gut transection and reanastomosis, SBS rats (group C) suffered 75% small gut resection, and finally, Group D suffered gut resection and treated with a synbiotic cocktail from day 7 before the surgery to day 14 after it. Intestinal structural changes and BT to mesenteric lymph nodes, liver, portal blood, and peripheral blood were detected on day 15 post-surgery. Treatment with a synbiotic cocktail led to a considerable reduction in bacterial translocation to liver and portal vein (degree II) compared with SBS untreated rats. Also, synbiotic administration significantly increased jejunum and ileum villus height and crypt depth, ileum villus width, and percentage of goblet cells in jejunum and ileum compared with SBS rats. In the rat model of short bowel syndrome, L. acidophilus, and pectin, as a potential synbiotic compound, could decrease the BT from the gut and improve the bowel adaptation.

Topics: Animals; Lactobacillus acidophilus; Pectins; Postoperative Complications; Rats; Sepsis; Short Bowel Syndrome

Adhesions are a common postoperative surgical complication. Liquid honey has been used intraperitoneally to reduce the incidence of these adhesions. However, solid barriers are considered more effective than liquids in decreasing postoperative intra-abdominal adhesion formation; therefore, a new pectin-honey hydrogel (PHH) was produced and its effectiveness was evaluated in a rat cecal abrasion model. Standardized cecal/peritoneal abrasion was performed through laparotomy in 48 adult Sprague-Dawley rats to induce peritoneal adhesion formation. Rats were randomly assigned to a control (C) and treatment (T) group. In group T, PHHs were placed between the injured peritoneum and cecum. Animals were euthanized on day 15 after surgery. Adhesions were evaluated macroscopically and adhesion scores were recorded and compared between the two groups. Inflammation, fibrosis, and neovascularization were histologically graded and compared between the groups.. In group C, 17 of 24 (70.8%) animals developed adhesions between the cecum and peritoneum, while in group T only 5 of 24 (20.8%) did (p = 0.0012). In group C, one rat had an adhesion score of 3, sixteen had scores of 2, and seven rats had scores of 0. In group T, four rats had adhesion scores of 2, one rat had an adhesion score of 1 and nineteen have score 0 (p = 0.0003). Significantly lower grades of inflammation, fibrosis, and neovascularization were seen in group T (p = 0.006, p = 0.001, p = 0.002, respectively).. PHH is a novel absorbable barrier that is effective in preventing intra-abdominal adhesions in a cecal abrasion model in rats.

Topics: Animals; Apitherapy; Biocompatible Materials; Honey; Hydrogels; Pectins; Postoperative Complications; Random Allocation; Rats; Rats, Sprague-Dawley; Tissue Adhesions

The formation of fibrous tissue is part of the natural healing response following a laminectomy. Severe scar tissue adhesion, known as epidural fibrosis, is a common cause of failed back surgery syndrome. In this study, by combining the advantages of drug treatment with a physical barrier, an ibuprofen-conjugated crosslinkable polygalacturonic acid and hyaluronic acid hydrogel was developed for epidural fibrosis prevention. Conjugation was confirmed and measured by 1D(1)H NMR spectroscopy.In vitroanalysis showed that the ibuprofen-conjugated polygalacturonic acid-hyaluronic acid hydrogel showed low cytotoxicity. In addition, the conjugated ibuprofen decreased prostaglandin E2production of the lipopolysaccharide-induced RAW264.7 cells. Histological data inin vivostudies indicated that the scar tissue adhesion of laminectomized male adult rats was reduced by the application of our ibuprofen-conjugated polygalacturonic acid-hyaluronic acid hydrogel. Its use also reduced the population of giant cells and collagen deposition of scar tissue without inducing extensive cell recruitment. The results of this study therefore suggest that the local delivery of ibuprofenviaa polygalacturonic acid-hyaluronic acid-based hydrogel reduces the possibility of epidural fibrosis.

Topics: Animals; Anti-Inflammatory Agents, Non-Steroidal; Cicatrix; Drug Carriers; Epidural Space; Hydrogel, Polyethylene Glycol Dimethacrylate; Ibuprofen; Laminectomy; Male; Mice; Pectins; Postoperative Complications; Rats; Rats, Sprague-Dawley; RAW 264.7 Cells; Tissue Adhesions; Wound Healing

Pectin is known to delay gastric emptying and alleviate dumping symptoms when ingested with hyperosmolar, glucose-containing meals. As the treatment of dumping syndrome includes frequent, small dry meals, the effect of pectin ingested in muffins was tested in five patients with severe, intractable dumping syndrome after gastric resection. Ingestion of 99mTc-DTPA-labelled muffins containing 5 g pectin did not alleviate dumping symptoms or delay gastric emptying compared with muffins without pectin. Pectin does not seem to be beneficial as a supplement in the conventional dietary management of post-gastrectomy dumping.

Topics: Aged; Dumping Syndrome; Food; Gastric Emptying; Humans; Middle Aged; Pectins; Postoperative Complications; Stomach

Pectin has been shown to minimise the fall in blood glucose seen in patients who are troubled by hypoglycaemia attacks after gastric surgery. We therefore performed 50 g glucose tolerance tests with and without 14.5 g pectin on 11 post-gastric surgery patients. After pectin, the high postprandial levels of glucose, insulin, and enteroglucagon were significantly reduced as was the fall in blood glucose between 90 and 120 minutes. These effects of pectin may reflect slower uptake of glucose from the gastrointestinal tract and provide evidence to support the use of unabsorbable carbohydrate gelling agents in treating hypoglycaemia after gastric surgery.

Topics: Adult; Aged; Blood Glucose; Female; Food; Gastrectomy; Gastric Emptying; Gastrointestinal Hormones; Glucose Tolerance Test; Humans; Hypoglycemia; Insulin; Male; Middle Aged; Pectins; Postoperative Complications; Vagotomy

Topics: Abdomen; Adenosine Diphosphate; Amines; Blood Sedimentation; Centrifugation; Cold Temperature; Densitometry; Dextrans; Epinephrine; Hematocrit; Heparin; Humans; Methods; Norepinephrine; Pectins; Postoperative Complications; Serotonin; Surgical Procedures, Operative; Temperature