THE ROLE OF LACTULOSE IN THE PREVENTION OF BACTERIAL TRANSLOCATION INSURGICAL TRAUMA

Surgical trauma (ST) is one of the causative factor of bacterial trans location. In this study we investigated the prevention of bacterial tr anslocation with lactulose in a surgical trauma model. The study was d esigned in 3 experimental groups consisting of 15 rats in each. Group 1 was sham operated controls, group 2 was ST+physiologic saline treate d and group 3 was ST+lactulose treated animals. Lactulose and physiolo gic saline were given by ore-gastric intubation in a dose of 2 ml of 3 3.5% solution/d and 2 ml/d respectively starting 3 days prior to surge ry. Bacterial translocation was investigated 48 hours after the operat ions. In sham operated controls only 1 bacterial translocation to the mesenteric lymph nodes (MLN) was observed. In the ST+physiologic salin e treated group bacterial translocation to the MLN and portal venous b lood (PVB) were significantly increased compared with both sham operat ed controls and the ST+lactulose treated group (p < 0.001). In rats wi th lactulose treatment the results of caecal bacterial counts showed a significant decrease in the number of gram-negative aerobes and facul tative anaerobe bacteria (P < 0.01) and a significant increase in the number of lactobacilli (p < 0.001) compared to the sham operated contr ols. Measurement of the mucosal height showed a significant increase a t the terminal ileum and the caecum compared with the sham operated co ntrols and the surgical trauma+physiologic saline treated group (p < 0 .001). We conclude that oral lactulose treatment 3 days prior to the s urgical trauma, reduced the incidence of bacterial translocation to th e MLN and PVB.