engleski

Histopathology Changes of Gut Mucosa during Anesthesia and Abdominal Surgical Procedures

AIM: A perfusion and integrity of small bowel mucosa were examined during anesthesia and surgery on open abdomen in 60 patients in various length treatments. MATERIAL AND METHODS: Patients (44 man, 16 woman) age range was 21 to 80 years (mean age 58 years). During the surgery, two samples of the intestinal mucosa were removed: T0 at the beginning of the procedure, and TN at the end (N = treatment duration in hours &#8211; 2 to 7 hours). All the biopsies were examined and classified according to the observed mucosal injury into 4 grades (Knichwitz: Crit Care Med 1998 ; 26:1550-7): grade 0 &#8211; no injury, grade 1 &#8211; isolated hemorrhage in lamina propria, grade 2 &#8211; lifting of the villus epithelium and isolated hemorrhage, grade 3 &#8211; damaged villi and hemorrhage, grade 4 &#8211; damaged villi and ulcerations with necrosis. RESULTS: The changes of intestinal mucosa were found in 31 patients (51.7%): in 19 patients (31.7%) grade 1 changes were recorded, in 10 patients (16.7%) grade 2, and in 2 patients (3.3%) grade 3. Grade 4 lesions were not recorded. CONCLUSIONS: During the anesthesia and surgery on open abdomen, the length of the procedure influences the grade of the intestinal mucosa injury. Aggravation of the patohistological changes in intestinal mucosa correlates with high lactate blood level (p<0.001), proving that the cause of these changes is connected with tissue hypoxia.

: intestinal mucosa; anesthesia; abdominal surgery; anoxia

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