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Heat preconditioning prevents oxidative stress‐induced damage in the intestine and lung following surgical manipulation. BJS 2003; 90: 473-481.

Published: 10th February 2003

Authors: S. Thomas, A. Pulimood, K. A. Balasubramanian

Background

The intestine is increasingly recognized as a primary effector of distant organ damage, such as lung, following abdominal surgery. Surgical manipulation of the intestine generates oxygen free radicals resulting in mucosal damage. Heat preconditioning has been proposed to prevent various stress‐induced alterations in cells and tissues, including oxidative stress. This study examined the effect of heat preconditioning on oxidative stress‐induced damage to the intestine and lung, following surgical manipulation.

Method

Control rats and rats pretreated with heat were subjected to surgical manipulation by opening the abdominal wall and handling the intestine as done during laparotomy. Intestine and lung were assessed for damage by histology and markers of oxidative stress.

Results

Surgical manipulation resulted in ultrastructural changes in the intestine. Biochemical alterations in the enterocytes were evident, with increased xanthine oxidase activity resulting in production of superoxide anion and with a decrease in antioxidant status. Gut manipulation also resulted in neutrophil infiltration and oxidative stress in the lung as assessed by histology, myeloperoxidase activity, lipid peroxidation and antioxidant status. Heat conditioning before surgical manipulation had a protective effect against this intestinal and lung damage.

Conclusion

This study suggests that mild whole‐body hyperthermia before surgery might offer protection from postoperative complications. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

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