[Surgical physiopathology. New results of importance for optimization of the postoperative course].
Complications after major surgery may be related to factors in the surgical stress response with endocrine-metabolic and inflammatory changes. In order to prevent these complications, it is important to understand the stress reaction of each organ system. The inflammatory response may be partly prevented by a minimal invasive surgical technique or by preoperative administration of high-dose steroids. Prevention of the endocrine-metabolic changes is best achieved with neural blockade. Unimodal intervention cannot eliminate morbidity and mortality after major surgery. Thus, multi-modal intervention with attenuation of the surgical stress response, effective dynamic treatment of pain, enforced mobilisation, and nutrition should be employed when possible.
H:S Hvidovre Hospital, kirurgisk sektion, gastroenheden.
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Rosenberg
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Kehlet
D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects; D011183:Postoperative Complications / Q000378:metabolism / Q000503:physiopathology* / Q000517:prevention & control; D011379:Prognosis; D013312:Stress, Physiological; D013514:Surgical Procedures, Operative / Q000009:adverse effects