Dexmedetomidine enhances recovery after gastrointestinal cancer surgery by protecting the endothelial glycocalyx - A randomized, double-blind, placebo-controlled study

Sep 28, 2026

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Vascular endothelial glycocalyx (VEG) integrity is essential for vascular barrier function, inflammation control, and microcirculatory homeostasis. Surgical stress and systemic inflammation can degrade the glycocalyx, causing endothelial dysfunction and worse postoperative outcomes. Dexmedetomidine (DEX), an α2-adrenergic agonist with anti-inflammatory and organ-protective properties, may limit glycocalyx degradation, but gastrointestinal cancer surgical evidence remains limited. This randomized, double-blind, placebo-controlled trial evaluates whether perioperative DEX attenuates inflammation-induced VEG degradation and preserves endothelial barrier function in patients undergoing gastrointestinal cancer resection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Background

Aim

Methods

Results

| W | J | G | S | World Journal of
Gastrointestinal Surgery | | --- | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastrointest Surg 2025 December 27; 17(12): 114628 DOI: 10.4240/wjgs.v17.i12.114628 ISSN 1948-9366 (online) ORIGINAL ARTICLE Clinical Trials Study Dexmedetomidine enhances recovery after gastrointestinal cancer surgery by protecting the endothelial glycocalyx: A randomized, double-blind, placebo-controlled study Rong Zeng, Chao-Liang Tang, Yue Zhao, Rui-Xiang Wang, Yun Fang, Xian-Wen Hu Specialty type: Gastroenterology and hepatology Provenance and peer review: Unsolicited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade B, Grade C Novelty: Grade B, Grade C Creativity or Innovation: Grade C, Grade C Scientific Significance: Grade B, Grade C P-Reviewer: Canbaz M, MD, Türkiye Received: September 24, 2025 Revised: October 1, 2025 Accepted: November 3, 2025 Published online: December 27, 2025 Processing time: 92 Days and 3.2 Hours Rong Zeng, Xian-Wen Hu, Department of Anesthesiology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230031, Anhui Province, China Rong Zeng, Yue Zhao, Rui-Xiang Wang, Yun Fang, Department of Anesthesiology, Anhui Provincial Cancer Hospital, Hefei 230031, Anhui Province, China Chao-Liang Tang, Department of Anesthesiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230031, Anhui Province, China Chao-Liang Tang, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230031, Anhui Province, China Xian-Wen Hu, Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei 230601, Anhui Province, China Corresponding author: Xian-Wen Hu, PhD, Department of Anesthesiology, The Second Affiliated Hospital of Anhui Medical University, No. 678 Furong Road, Hefei 230601, Anhui Province, [China.](China. huxianwen001@163.com)[ huxianwen001@163.com](China. huxianwen001@163.com) Abstract BACKGROUND The 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. AIM To determine whether perioperative DEX attenuates surgical inflammation-induced VEG degradation and preserves endothelial barrier function in patients undergoing gastrointestinal cancer resection. WJGS [https://www.wjgnet.com](https://www.wjgnet.com) 1 December 27, 2025 Volume 17 Issue 12 Zeng R et al. DEX and endothelial glycocalyx protection METHODS This 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)

FAQs

What is the main objective of the study?

To determine whether perioperative dexmedetomidine attenuates surgical inflammation-induced endothelial glycocalyx degradation and preserves endothelial barrier function in gastrointestinal cancer resection patients.

How was dexmedetomidine administered and how was the trial designed?

A prospective, single-center randomized, double-blind, placebo-controlled trial assigned 110 elective gastric or colorectal tumor resection patients to intraoperative DEX or saline placebo in a 1:1 ratio.

What were the key outcomes related to endothelial glycocalyx and recovery?

DEX reduced endothelial glycocalyx injury markers such as lower plasma syndecan-1 and heparan sulfate, improved microcirculatory parameters, and enhanced recovery outcomes including higher QoR-15 scores, shorter hospital stay, and fewer 30-day complications.

Sep 28, 2026

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