Mf. Ozcelik et al., THE ROLE OF LACTULOSE IN THE PREVENTION OF BACTERIAL TRANSLOCATION INSURGICAL TRAUMA, Acta Chirurgica Belgica, 96(1), 1996, pp. 44-48
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.