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    Surgery

    Researchers may have identified a way to decrease complications from infection after certain types of gastrointestinal surgeries. In addition to providing a way for bacteria to enter the body, gastrointestinal surgery can expose the rest of the body to potentially dangerous bacteria from the digestive tract, sometimes for prolonged periods during lengthy procedures.

    Patients with serious or complex illnesses often have difficulty fighting infection, and the potentially dangerous bacteria that live in the digestive tract pose a very real threat for these patients. Because of this, surgical patients are frequently given antibiotics to prevent infection from taking hold.

    A team of U.S. researchers from around the country conducted a study, which was recently published in the journal "Archives of Surgery," to determine whether using an immune-enhancing agent, a substance designed to help the body fight infection, in combination with antibiotics would reduce complications and deaths resulting from infection after gastrointestinal surgery.

    They studied 1,249 patients scheduled for gastrointestinal surgery. All were considered at high risk for complications, based on a list of risk factors. Patients were placed into one of two surgical categories: colorectal (surgeries involving the colon or rectum) and noncolorectal (surgeries not involving the colon or rectum).

    All patients were given antibiotics according to a standardized protocol. In addition, they were either given PGG-glucan or a placebo, once before surgery and at three scheduled intervals after surgery. PGG-glucan is an immune-enhancing agent that assists the body to defend itself against bacteria including Staphylococcus aureus and Escherichia coli, two common bacteria that can be deadly, particularly in patients who are already ill or weak.

    For patients who underwent noncolorectal surgeries, such as gastrectomy (removal of part of stomach), biliary and gastric bypass, small intestine procedures, or esophagectomy (removal of part of esophagus), PGG-glucan reduced serious infections and death by 39 percent when compared with patients who received only a placebo. Interestingly, this effect was not observed in the patients who underwent colorectal procedures. The researchers believe that this is because of the difference in risks faced by patients in each category. Patients having noncolorectal surgery may have longer, more complex surgeries and are often malnourished, which limits their ability to combat infection. PGG-glucan may offset these factors by enhancing the body's ability to fight infection. Conversely, much of the risk involved in colorectal surgery is related to the large number of bacteria that may not be able to be contained by the PGG-glucan.

    These researchers believe that future surgical treatment of gastrointestinal disorders will focus on augmenting the body's ability to defend itself against infection, in addition to preventing and limiting the growth of bacteria with antibiotics.


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