Hydroxyethyl starch solution: Is it a new alternative way of treatment in bacterial translocation?

In this experimental study, the effects of mannitol and hydroxyethyl starch solution (HES) on bacterial translocation were evaluated in a rat model of simple mechanical bowel obstruction. The mechanical bowel obstruction was created by ligation of the ileum 1 cm proximal to the ileocecal valve, Excl uding the control group (n=7), the rats were given 2 mi of mannitol or 2 mi of 6% hydroxyethyl starch solution intraperitoneally during the procedure. Relaparotomy was made and segmental heal resection, total mesenteric lymph node excision and removal of tissue sample of liver were performed 24 h af ter the mechanical bowel obstruction, both for histopathological and microb iological examination. The rates of colony formation in the mesenteric lymp h nodes after the mechanical bowel obstruction were 71% (5/7) in control an imals, 43% (3/7) in animals given mannitol and only 14% (1/7) in animals gi ven HES, In the liver samples observed for the bacterial translocation, the corresponding figures were 14% (1/7), 28% (2/7) and 0% (0/7) respectively, The difference between hydroxyethyl starch solution and control groups were statistically significant (P < 0.04), The bacterial population/g tissue ob tained from intraluminal bacterial cultures of the ileum was also depressed in hydroxyethyl starch solution group when compared to the control (P < 0. 03), As a result, we confirmed that hydroxyethyl starch solution, a plasma volume expander, depressed the bacterial translocation to the mesenteric ly mph nodes and liver and also reduced intraluminal bacterial overgrowth in t he simple mechanical bowel obstruction model of rats. We believe that hydro xyethyl starch solution may be an alternative therapeutic agent for the pre -operative fluid resuscitation in simple mechanical bowel obstruction.