PROPHYLAXIS AGAINST POSTOPERATIVE COMPLICATIONS IN GASTROENTEROLOGY

Gastrointestinal surgery results in pain, profound endocrine metabolic changes and organ dysfunction, immunosuppression and decreased resist ance to infection, fatigue and convalescence. The main pathogenetic me chanism is the surgical stress response, which may be reduced by minim al invasive (laparoscopic) surgical techniques and afferent neural and perhaps humoral mediator blockade. Subsequently, these techniques hav e been documented as reducing a variety of postoperative morbidity par ameters. A unifying concept for control of the postoperative period is presented as a combined effort to enhance preoperative information, s tress reduction and sufficient functional pain relief allowing early m obilization and oral nutrition. Preliminary data, in combination with laparoscopic surgery, suggest that this approach improves outcome sign ificantly.