Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (9): 48-53.doi: 10.6040/j.issn.1671-7554.0.2019.527

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Association between preoperative oral polysaccharide solution and insulin resistance in patients with colorectal cancer

WU Chengwei, SUN Boshi, ZHOU Junde, JIANG Tianming, CHI Qiang   

  1. Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin 150081, Heilongjiang, China
  • Published:2022-09-27

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Abstract: Objective To explore the safety, feasibility and advantages of preoperative oral polysaccharide solution by comparing postoperative insulin resistance and complications between preoperative oral polysaccharide solution and placebo for patients undertaking elective colorectal surgery. Methods The clinical data of 80 patients with colorectal cancer treated during Apr. 2017 and Dec. 2018 were retrospectively analyzed, including 40 patients in the polysaccharide solution group and 40 in the control group(placebo group). The general data, homeostasis model assessment-2 insulin resistance index(HOMA2-IR), homeostasis model assessment-2 insulin sensitivity index(HOMA2-%S), fasting plasma glucose(FPG), fasting insulin(FINS), white blood cell count(WBC), C-reactive protein(CRP), procalcitonin(PCT), and postoperative complications were compared between the two groups. Results (1) There were no statistical differences in the general data between the two groups and no aspiration occurred during operation. (2) The FPG, FINS and HOMA2-IR of both groups increased after operation, while HOMA2-%S decreased(P<0.05). (3) The polysaccharide solution group had lower FPS, FINS and HOMA2-IR but higher HOMA2-%S on the 1st and 3rd postoperative day(POD1, POD3)than the control group(P<0.05). (4) The polysaccharide solution group had lower postoperative WBC 山 东 大 学 学 报 (医 学 版)57卷9期 -吴成威,等.术前口服多糖溶液对结直肠癌患者术后胰岛素抵抗的关联性研究 \=-and CRP(P<0.05). (5) The polysaccharide solution group had shorter first anus exhausting time(P<0.05). (6) There were no significant differences in postoperative infectious complications, length of stay(LOS)and hospitalization costs between the two groups(P>0.05). Conclusion Compared with the placebo, preoperative oral polysaccharide solution does not increase the risk of aspiration. Instead, it significantly reduces insulin resistance, increases insulin sensitivity, and promotes the recovery of intestinal function. However, there are no significant differences in the length of stay, hospitalization costs and complications between the usage of placebo and polysaccharide solution.

Key words: Polysaccharide solution, Carbohydrate, Colorectal cancer, Insulin resistance, Complications

CLC Number: 

  • R656
[1] Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anesthesia[J]. Am J Obstet Gynecol, 1946, 52: 191-205.
[2] Thorell A, Efendic S, Gutniak M, et al. Insulin resistance after abdominal surgery[J]. Br J Surg, 1994, 81(1): 59-63.
[3] Thorell A, Efendic S, Gutniak M, et al. Development of postoperative insulin resistance is associated with the magnitude of operation[J]. Eur J Surg, 1993, 159(11-12): 593-599.
[4] Nygren J, Thorell A, Ljungqvist O. Preoperative oral carbohydrate therapy[J]. Curr Opin Anaesthesiol, 2015, 28(3): 364-369.
[5] Çakar E, Yilmaz E, Çakar E, et al. The effect of preoperative oral carbohydrate solution intake on patient comfort: a randomized controlled study[J]. J Perianesth Nurs, 2017, 32(6): 589-599.
[6] Tudor-Drobjewski BA, Marhofer P, Kimberger O, et al. Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric anaesthesia[J]. Br J Anaesth, 2018, 121(3): 656-661.
[7] Kehlet H. Multimodal approach to control postoperative pathophysiology and rehabilitation[J]. Br J Anaesth, 1997, 78(5): 606-617.
[8] 陈凛, 陈亚进, 董海龙, 等. 加速康复外科中国专家共识及路径管理指南(2018版)[J]. 中国实用外科杂志, 2018, 38(1): 1-20.
[9] Gustafsson UO, Scott MJ, Hubner M, et al. Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery(ERAS)society recommendations: 2018[J]. World J Surg, 2019, 43(3): 659-695.
[10] 郭晶, 邬维娜, 蔡学联, 等. 医务人员禁食禁饮方案实践指南的认知及依从现状调查[J]. 中华现代护理杂志, 2017, 23(35): 4460-4464. GUO Jing, WU Weina, CAI Xuelian, et al. Cognition and compliance of medical staff on fasting and water deprivation scheme from practice guideline[J]. Chinese Journal of Modern Nursing, 2017, 23(35): 4460-4464.
[11] 孙志坚, 孙旭, 孙伟桐, 等. 我国创伤骨科医生围手术期饮食管理现状调查[J]. 中华创伤骨科杂志, 2018, 20(8): 683-688. SUN Zhijian, SUN Xu, SUN Weitong, et al. Perioperative fasting management by traumatic surgeons in China[J]. Chinese Journal of Orthopaedic Trauma, 2018, 20(8): 683-688.
[12] Falconer R, Skouras C, Carter T, et al. Preoperative fasting: current practice and areas for improvement[J]. Updates Surg, 2014, 66(1): 31-39.
[13] Worknehe A, Ambrose R, Alula BN, et al. Preoperative fasting times in elective surgical patients at a referral Hospital in Botswana[J]. Pan Afr Med J, 2016, 23:102. doi: 10.11604/pamj.2016.23.102.8863.
[14] Thorell A, Nygren J, Ljungqvist O. Insulin resistance: a marker of surgical stress[J]. Curr Opin Clin Nutr Metab Care, 1999, 2(1): 69-78.
[15] Shohat N, Muhsen K, Gilat R, et al. Inadequate glycemic control is associated with increased surgical site infection in total joint arthroplasty: a systematic review and meta-analysis[J]. J Arthroplasty, 2018, 33(7): 2312-2321.
[16] Wang Y, Hu S, Ying H, et al. Postoperative tight glycemic control significantly reduces postoperative infection rates in patients undergoing surgery: a meta-analysis[J]. BMC Endocr Disord, 2018, 18(1): 42. doi: 10.1186/s12902-018-0268-9.
[17] Lachmann G, Wollersheim T, Spies C. Severe perioperative hyperglycemia attenuates postoperative monocytic function, basophil count and T cell activation[J]. Minerva Anestesiol, 2017, 83(9): 921-929.
[18] Mraovic B, Suh D, Jacovides C, et al. Perioperative hyperglycemia and postoperative infection after lower limb arthroplasty[J]. J Diabetes Sci Technol, 2011, 5(2): 412-418.
[19] Mesotten D, Preiser JC, Kosiborod M. Glucose management in critically ill adults and children[J]. Lancet Diabetes Endocrinol, 2015, 3(9): 723-733.
[20] Gianotti L, Biffi R, Sandini M, et al. Preoperative oral carbohydrate load versus placebo in major elective abdominal surgery(PROCY): a randomized, placebo-controlled, multicenter, phase III trial[J]. Ann Surg, 2018, 267(4): 623-630.
[21] Gustafsson UO, Nygren J, Thorell A, et al. Pre-operative carbohydrate loading may be used in type 2 diabetes patients[J]. Acta Anaesthesiol Scand, 2008, 52(7): 946-951.
[22] Näveri H, Tikkanen H, Kairento AL, et al. Gastric emptying and serum insulin levels after intake of glucose-polymer solutions[J]. Eur J Appl Physiol Occup Physiol, 1989, 58(6): 661-665.
[23] Esaki K, Tsukamoto M, Sakamoto E, et al. Effects of preoperative oral carbohydrate therapy on perioperative glucose metabolism during oral-maxillofacial surgery: randomised clinical trial[J]. Asia Pac J Clin Nutr, 2018, 27(1): 137-143.
[24] Thiele RH, Raghunathan K, Brudney CS, et al. American society for enhanced recovery(ASER)and perioperative quality initiative(POQI)joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery[J]. Perioper Med, 2016, 5(1): 24. doi: 10.1186/s13741-016-0049-9.
[25] Nygren J, Thorell A, Jacobsson H, et al. Preoperative gastric emptying. Effects of anxiety and oral carbohydrate administration [J]. Ann Surg, 1995, 222(6): 728-734.
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