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Post operative changes of rapid turnover proteins in elective gastrointestinal surgery.

BACKGROUND/AIMS
This study was performed to examine the changes in rapid turnover proteins (RTPs), such as retinol-binding protein, transthyretin and transferrin, which are known nutritional parameters, during the perioperative period for digestive system operations.


METHODOLOGY
The study was performed with 62 subjects who underwent elective surgery of the digestive system. The RTP measurements were performed approx. seven times for each subject (approx. 20 times in total) from the preoperative period to the 14th postoperative day. For 20 subjects who exhibited no recurrence of a malignant tumor, additional measurements were performed 6 to 12 months after the operation. RTPs were measured more than 1,400 times in total for all subjects.


RESULTS
The three types of RTPs all exhibited similar changes, but the largest change was observed for retinol-binding protein. The changes in RTPs were significantly larger than those for albumin. RTP levels were lowest on the 3rd postoperative day and gradually increased thereafter. The RTP levels recovered to approx. 80% of the preoperative values on the 14th postoperative day. In the measurements performed 6 to 12 months after the operation, the levels recovered to 90% or higher of the preoperative values. No significant differences were observed between the cases utilizing different operation methods. The administration of fresh frozen plasma had no impact on the postoperative changes. No correlation was observed between the calories obtained by oral intake during the period from the 5th to 10th postoperative days and the changes in RTPs.


CONCLUSION
The study results suggested that changes in RTPs would not affected by the calories obtained by oral intake during the early postoperative days. In patients who returned to their daily life after an invasive surgery or reconstruction of the digestive tract, RTP levels were restored to the preoperative values 6 to 12 months after the operation.