[Postoperative ileus: part II (Clinical therapy)].

Abstract:

:To avoid or reduce postoperative ileus, the operative trauma should be minimized and epidural anesthesia for spinal inhibition of the sympathetic nervous system or i. v. lidocaine should be used, all of which probably act by reducing visceral afferent nerve fiber activity. Recent data suggest that perioperative fluid restriction might reduce postoperative ileus. Epidural anesthesia with local anesthetics and replacing opioids by non-steroidal anti-inflammatory drugs (NSAIDs) for postoperative pain treatment improve the recovery of gastrointestinal motility disturbances. Prior to the operation, the patient should be informed regarding postoperative motility disorders, its length and the presumed resumption of oral food intake, which has been shown to shorten hospital stay. Early postoperative food intake stimulates small and large bowel motility via interenteric reflex arches, avoids i. v. lines and renders discharge acceptable for the patient. Treatment of postoperative ileus includes osmotic laxatives and prokinetic drugs like erythromycine and acetylcholinesterase inhibitors. By combining epidural anesthesia and the sparse use of i. v. opioids with early food intake and, if necessary, laxatives or prokinetics, postoperative ileus should be coped adequately. Nevertheless, the development of new specific prokinetic drugs with minimal or no side effects should remain a target for drug companies to further improve treatment of postoperative ileus.

journal_name

Zentralbl Chir

authors

Kreis ME,Kasparek MS,Becker HD,Jehle EC,Zittel TT

doi

10.1055/s-2003-38797

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

320-8

issue

4

eissn

0044-409X

issn

1438-9592

journal_volume

128

pub_type

杂志文章,评审
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    authors: Giebel GD,Knoblich A

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  • [Microbiological sepsis screening in surgical ICU patients with the "lightCycler" Septifast test--a pilot study].

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    journal_title:Zentralblatt fur Chirurgie

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    authors: Schöffel U,Häring R,Farthmann EH

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  • [Early morbidity and fatality following carotid disobliteration].

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    authors: De Vleeschauwer P,Schmitz-Rixen T,Kraus A,Horsch S

    更新日期:1985-01-01 00:00:00

  • [Surgical therapy of complicated diverticular disease].

    abstract::From 1975-1989 55 patients were operated on for complicated diverticular disease at our unit. Intraoperative we found the following complications: 21 walled of perforations, 22 stenosis of the sigmoid colon combined with obstruction of the small and/or large bowel, 8 free perforations with generalized, faecal peritoni...

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    authors: Huber MA,Woisetschläger R,Sulzbacher H,Wayand W

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  • [Interdisciplinary cooperation between anaesthesiology and surgery from the surgeon's point of view (author's transl)].

    abstract::The development of anaesthesiology has brought about a great variety of problems e.g. unforeseen capacities, money, vacancies and equipment. The patients welfare, of course necessitates the establishment of anaesthesiological departments wherever operations are being performed. We believe that in hospitals without ana...

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    doi:

    authors: Bünte H

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  • [Treatment of unstable thoracolumbar spinal injuries--determination of its present status and a preliminary report on transpedicular stabilization].

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    authors: Wendsche P,Michek J,Unger C

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    abstract::Blunt abdominal injuries are associated with a high mortality rate. Particularly in children, the most important cause of deaths is delay in diagnosis and treatment. In recent years, peritoneal lavage has been gaining importance as a diagnostic method in such injuries.--Between 1977 to 1980, 315 patients (under the ag...

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    authors: Belgerden S,Emre A,Alper A,Cakaçi E,Emre S,Damirkol K

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    authors: Gräbner D

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  • [Situation-adjusted Treatment of Haemorrhoidal Disease].

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    abstract:BACKGROUND:In spite of dynamic development of modern diagnostic and therapeutic methods, the long-term results of surgical therapy in pancreatic cancer are still unsatisfying. The aim of this study was to analyse long-term results of surgical palliation for pancreatic cancer in a pancreatic surgery centre. METHODS:We ...

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  • [Laparoscopic therapy of colorectal cancer--wishful thinking or realism?].

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    abstract::The number of patients with a diagnosis of cancer is alarming: according to new figures from the Robert Koch Institute about 435 000 patients are diagnosed annually in Germany. 210 000 patients die annually of this diagnosis. Even if no significant progress in prevention has been achieved, in 2020 about 25 % more case...

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    abstract::Background An enterothorax with herniation of bowel segments through a diaphragmatic defect is a rare postoperative complication, which can occur in the early postoperative period as well as several months or even years after the primary procedure. In virtually all cases, this diagnosis requires surgical treatment wit...

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    abstract::In 1973 the observation was published that in patients who had received non specific blood transfusions before kidney transplantation graft survival was improved. An immunosuppressive effect of blood transfusion was suggested. Indeed, modulation on the cellular and humoral immunologic system has been demonstrated duri...

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    更新日期:1991-01-01 00:00:00

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    更新日期:1994-01-01 00:00:00

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    更新日期:1979-01-01 00:00:00

  • [Management of ipsilateral fractures of the femur shaft and proximal femur--therapy overview and current management].

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    更新日期:1995-01-01 00:00:00

  • [Simulation of a hypophyseal tumor in carotid-ophthalmic aneurysms].

    abstract::Case report. A 59 year old woman was thought to suffer from a neoplasm of the hypophysis. This "tumour" was simulated by a giant aneurysm of the infraorbital segment of the left carotid artery. For technical reasons the left carotid artery had not been demonstrated in the angiogram. For final clarification CT as well ...

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