Differences in gut integrity following abdominal surgery according to the magnitude of the surgical stress

Background: An increase in serum diamine oxidase (DAO) activity reflects in testinal mucosal damage. This was used to estimate the effect of surgical s tress after elective abdominal surgery on gut integrity. Methods: Patients with gastrointestinal tract cancers were placed in either group T (transthoracic esophagectomy for esophageal cancer, n = 9) or grou p L (laparotomy, n = 10). The serum DAO activity was measured pre-operative ly, and on postoperative days 1, 3, and 8. Results: Transthoracic esophagectomy was associated with a more extensive s tress than the operations in group L, as measured by the intra-operative bl ood loss, the amount of blood transfused, and the operative time (P = 0.007 , P = 0.0002, P = 0.0011, respectively). Following surgery, the serum DAO a ctivity was decreased markedly in all patients in group T. In contrast, the activity was unchanged in group L (P = 0.04). Conclusions: The severity of the surgical insult plays a significant role i n the decrease in serum DAO activity. These results suggest that surgical s tress influences gut integrity following elective abdominal surgery.