Peritoneal microdialysis. Early diagnosis of anastomotic leakage after low anterior resection for rectosigmoid cancer.

BACKGROUND: The aim of the present study was to evaluate the efficacy and safety of intraperitoneal microdialysis in early detection of anastomotic leakage after low anterior resection for rectosigmoid cancer. METHODS: In a series of 116 consecutive patients scheduled for low anterior resection for rectosigmoid cancer, a total of 50 patients consented to participate. Peritoneal microdialysis was performed by a 1 mm thin catheter anchored in close proximity to the anastomosis. Five patients were excluded due to catheter malfunction. Average microdialysis time in the remaining 45 patients was 177.6 (80-252) hours. Samples were collected every 4-hours, and the concentration of glucose, lactate, pyruvate and glycerol was measured. RESULTS: Four patients developed symptomatic anastomotic leakage. Two patients developed non-abdominal sepsis. In 38 patients the postoperative course was uncomplicated, considering major complications, and they served as controls. In three patients with late (>or=10 days) anastomotic leakage a significant increase in concentration of lactate and lactate/pyruvate ratio (L/P-ratio) was seen several days prior to development of clinical symptoms. In one patient with early anastomotic leakage it coincided with the development of clinical symptoms. In the two patients with non-abdominal sepsis the values were within normal range. CONCLUSION: Peritoneal microdialysis is a safe and promising tool in early diagnosis of anastomotic leakage after low anterior resection for rectosigmoid cancer.

Puerperal lactation inhibition with a novel 8 alpha-aminoergoline (CU 32-085).

The clinical efficacy of CU 32-085, a novel ergoline derivative, in puerperal lactation inhibition was investigated in 41 healthy postpartum women and compared with serum concentrations of prolaction (PRL) and CU 32-085. The women received 0.5 mg CU 32-085 twice daily for 14 days. In 40 women (i.e. 97%) treatment with CU 32-085 successfully inhibited lactation; slight to moderate breast activity appearing during the first few days receded spontaneously. 1 woman experienced full milk let-down on day 5 of treatment. No rebound lactational phenomena were recorded. 5 h after the initial dose, mean serum PRL concentrations decreased by 82% (from 169 to 30 ng/ml), and PRL values remained at that level during the course of treatment. The mean serum concentrations of CU 32-085 showed an inverse pattern compared to PRL. CU 32-085 was well tolerated, with transient slight to moderate dizziness, headache and nausea reported by 12 women (29%) following the initial dose. These disappeared after an average of 3 h. Routine safety chemistries remained within the normal range, and no statistically significant differences between the treatment group and the control group (25 normal nursing postpartum women) were encountered. It is concluded that CU 32-085, a potent dopamine agonist, is an effective and well-tolerated treatment in the indication of postpartum lactation inhibition.