Elective abdominal surgery depresses muscle protein synthesis and increases subjective fatigue: Effects lasting more than 30 days
Article first published online: 6 DEC 2005
Copyright © 1990 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 77, Issue 7, pages 796–800, July 1990
How to Cite
Petersson, B., Wernerman, J., Waller, S.-O., von der Decken, A. and Vinnars, E. (1990), Elective abdominal surgery depresses muscle protein synthesis and increases subjective fatigue: Effects lasting more than 30 days. Br J Surg, 77: 796–800. doi: 10.1002/bjs.1800770725
- Issue published online: 6 DEC 2005
- Article first published online: 6 DEC 2005
- Manuscript Accepted: 28 JAN 1990
- Swedish Medical Research Council
- protein synthesis;
- muscle biopsy;
- nitrogen balance;
- muscle strength
Ten patients without metabolic disease undergoing elective cholecystectomy were studied before surgery and on days 3, 10, 20 and 30 after operation. Percutaneous muscle biopsies were taken and protein synthesis was determined from the total concentration and size distribution of ribosomes. The subjective feeling of fatigue was estimated using a visual analogue scale. The nitrogen balance was calculated at 20 days following surgery. The mean(s.e.m.) total concentration of ribosomes per milligram of DNA decreased by 27·5(6·6) per cent (P < 0·07), 44·5(6·5) per cent (P < 0·007), 48·3(8·9) per cent (P < 0·007) and 45·0(8·2) per cent (P<0·07) on days 3, 10, 20 and 30, respectively. By 30 days after surgery no sign of restoration of normality was seen. The relative proportion of polyribosomes had decreased by 20·4(6·4) per cent (P<0·05) on the third postoperative day and by 20·4(3·9) per cent (P < 0·07) on the tenth postoperative day and was restored to the preoperative level by day 20. The subjective fatigue score increased after operation and five of nine patients had not regained their preoperative scores 30 days after surgery. The daily nitrogen balance was negative for 5 days. The cumulated nitrogen losses were not restored until after 18 days following surgery. Elective abdominal surgery caused a sustained depression of protein synthesis for over 30 days, a longer period than previously presumed. These results show that long-term follow-up is required when the effect of different postoperative nutritional regimens are to be evaluated.