Metabolic changes during the defunctionalized stage after ileal pouch-anal anastomosis.

Overview

Metabolic changes between the preoperative period and the defunctionalized stage after ileal pouch-anal anastomosis were investigated in 21 patients. Aspects studied included weight change, renal function, liver function, lipid metabolism, and two hematologic parameters. Of 21 patients, 19 lost weight. Cholesterol levels decreased from 183 +/- 30 IU/1 to 122 +/- 48 IU/1 (P less than .0001). Triglyceride levels rose from 95 +/- 29 IU/1 to 190 +/- 86 IU/1 (P less than .01). Significant elevations were seen in values of four liver function tests: SGOT, SGPT, lactic dehydrogenase, and alkaline phosphatase (P less than .05). Blood urea nitrogen levels increased from 11.1 +/- 4.7 mg/100 ml to 21.8 +/- 24.8 mg/100 ml (P less than .05). Serum creatinine levels rose from 0.97 +/- .18 mg/100 ml to 1.5 +/- 1.2 mg/100 ml (P less than .05). Uric acid levels increased from 5.6 +/- 1.8 mg/100 ml to 7.5 +/- 2.3 mg/100 ml (P less than .001). Hemoglobin values did not change significantly. Platelet counts rose from 304,000 +/- 79,000 to 447,800 +/- 189,000 (P less than .05). Identification of these systematic alterations in metabolic parameters during the defunctionalized stage can aid the physician in management of these patients.