Therapeutic Targeting Research Group, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.
Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.
Drug Deliv Transl Res. 2023 Jan;13(1):37-53. doi: 10.1007/s13346-022-01179-6. Epub 2022 May 18.
General surgical procedures on the gastrointestinal tract are commonly performed worldwide. Surgical resections of the stomach, small intestine, or large intestine can have a significant impact on the anatomy and physiological environment of the gastrointestinal tract. These physiological changes can affect the effectiveness of orally administered formulations and drug absorption and, therefore, should be considered in rational drug formulation design for specific pathological conditions that are commonly associated with surgical intervention. For optimal drug delivery, it is important to understand how different surgical procedures affect the short-term and long-term functionality of the gastrointestinal tract. The significance of the surgical intervention is dependent on factors such as the specific region of resection, the degree of the resection, the adaptive and absorptive capacity of the remaining tissue, and the nature of the underlying disease. This review will focus on the common pathological conditions affecting the gastric and bowel regions that may require surgical intervention and the physiological impact of the surgery on gastrointestinal drug delivery. The pharmaceutical considerations for conventional and novel oral drug delivery approaches that may be impacted by general surgical procedures of the gastrointestinal tract will also be addressed.
全球范围内普遍开展胃肠道的普通外科手术。胃、小肠或大肠的外科切除术对胃肠道的解剖结构和生理环境有重大影响。这些生理变化会影响口服制剂的效果和药物吸收，因此在针对与外科干预相关的特定病理状况进行合理药物配方设计时应予以考虑。为了实现最佳药物输送，了解不同的外科手术如何影响胃肠道的短期和长期功能非常重要。手术干预的重要性取决于切除的具体部位、切除的程度、剩余组织的适应性和吸收能力以及潜在疾病的性质等因素。本文综述重点关注可能需要手术干预的胃和肠道区域的常见病理状况，以及手术对胃肠道药物输送的生理影响。还将讨论可能受胃肠道普通外科手术影响的常规和新型口服药物输送方法的药物考虑因素。
