Trial reportWorld journal of gastrointestinal surgery2025
Dexmedetomidine enhances recovery after gastrointestinal cancer surgery by protecting the endothelial glycocalyx: A randomized, double-blind, placebo-controlled study.
Trial report in World journal of gastrointestinal surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
backgroundThe vascular endothelial glycocalyx (VEG) plays a critical role in maintaining vascular barrier integrity, regulating inflammation, and ensuring microcirculatory homeostasis. Surgical stress and systemic inflammation can disrupt the glycocalyx, leading to endothelial dysfunction, impaired microcirculation, and adverse postoperative outcomes. dexmedetomidine (DEX), an α2-adrenergic agonist with anti-inflammatory and organ-protective properties, has been suggested in preclinical and clinical studies to mitigate glycocalyx degradation, yet evidence in gastrointestinal cancer surgery remains limited.
aimTo determine whether perioperative DEX attenuates surgical inflammation-induced VEG degradation and preserves endothelial barrier function in patients undergoing gastrointestinal cancer resection.
methodsThis was a prospective, single-center, randomized, double-blind, placebo-controlled trial conducted at the First Affiliated Hospital of University of Science and Technology of China. A total of 110 patients undergoing elective gastric or colorectal tumor resection were randomly assigned (1:1) to receive intraoperative DEX or saline placebo. Anesthesia and analgesia were standardized across groups. The primary outcome was plasma syndecan-1 concentration, a marker of endothelial glycocalyx injury, measured at four perioperative timepoints (T0-T3). Secondary outcomes included inflammatory biomarkers [interleukin-6 (IL-6), tumor necrosis factor-alpha, C-reactive protein, heparan sulfate], microcirculatory parameters [perfused vessel density (PVD), flow index, P(v-a)CO
resultsA total of 110 patients were randomized equally to the DEX or control group, with well-balanced baseline characteristics. Compared with controls, DEX significantly reduced postoperative infections (7%
conclusionPerioperative administration of DEX confers significant endothelial-protective effects by mitigating glycocalyx degradation, suppressing systemic inflammation, and promoting enhanced postoperative recovery. These findings support its clinical utility as a valuable adjunctive therapy in the perioperative management of patients undergoing oncologic gastrointestinal surgery.
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