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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2025; 17(12): 114628
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.114628
Published online Dec 27, 2025. doi: 10.4240/wjgs.v17.i12.114628
Dexmedetomidine enhances recovery after gastrointestinal cancer surgery by protecting the endothelial glycocalyx: A randomized, double-blind, placebo-controlled study
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 Pro
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 Tech
Xian-Wen Hu, Laboratory of Anesthesiology and Perioperative Medicine of Anhui Higher Education Institutes, Anhui Medical University, Hefei 230601, Anhui Province, China
Author contributions: Zeng R and Hu XW designed the research, performed the experiments, analyzed the data, and wrote the paper; Tang CL and Zhao Y contributed to methodology and conceptualization, and participated in writing—review and editing; Wang RX and Fang Y conducted data curation and experimental studies, analyzed the data, and participated in writing—review and editing.
Institutional review board statement: The study protocol was approved by the Institutional Ethics Committee of Anhui Provincial Cancer Hospital (approval No. 2024014).
Clinical trial registration statement: The trial was prospectively registered at https://www.chictr.org.cn/showproj.html?proj=221761 (No. ChiCTR2500109633).
Informed consent statement: Written informed consent was obtained from all participants prior to enrollment.
Conflict-of-interest statement: All authors declare no conflict of interest.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data are not publicly available due to privacy and ethical restrictions protecting patient confidentiality in accordance with the General Data Protection Regulation and institutional ethics committee requirements. The individual de-identified participant data (including biomarker values, hemodynamic parameters, and clinical outcomes) that support the findings of this study are available from the corresponding author upon reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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. huxianwen001@163.com
Received: September 24, 2025
Revised: October 1, 2025
Accepted: November 3, 2025
Published online: December 27, 2025
Processing time: 91 Days and 22.4 Hours
Revised: October 1, 2025
Accepted: November 3, 2025
Published online: December 27, 2025
Processing time: 91 Days and 22.4 Hours
Core Tip
Core Tip: This randomized controlled trial demonstrates that perioperative dexmedetomidine (DEX) infusion attenuates vascular endothelial glycocalyx degradation (as evidenced by reduced syndecan-1 and heparan sulfate levels) and suppresses systemic inflammation in patients undergoing gastrointestinal tumor resection. These mechanistic benefits were associated with improved microcirculatory perfusion, reduced postoperative complications, and enhanced recovery, including shorter hospital stay. The study identifies syndecan-1 as a potential biomarker for perioperative risk stratification and supports the integration of DEX as an endothelial-protective adjunct within Enhanced Recovery after Surgery protocols for oncologic surgery.