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Clin Colon Rectal Surg 2003; 16(2): 091-100
DOI: 10.1055/s-2003-40588
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Physiological, Metabolic, and Immunological Responses after Intestinal Resection

Kathrine Holte, Henrik Kehlet
  • Department of Surgical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark
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Publication History

Publication Date:
18 July 2003 (online)

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ABSTRACT

Major surgery leads to an activation of inflammatory and endocrine responses resulting in catabolism, immunosuppression, and adverse physiological effects in various organ systems. In addition, hypothermia, opioid administration, immobilization, and semistarvation may amplify the negative effects of the stress responses on perioperative organ physiology. Currently available options to modify the stress response activation per se are epidural local anesthetics, minimally invasive surgery, and a single high-dose glucocorticoid. Recent studies indicate that the stress-induced perioperative impairment in various organ functions may be profoundly reduced by multimodal rehabilitation programs aiming to control perioperative pathophysiology and thereby improve recovery.

KEYWORDS

Surgical stress - postoperative complications - postoperative analgesia - minimally invasive surgery

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