ABSTRACT
The most typical postoperative course is a slowly resolving anorexia, hypoperistalsis, and moderate distention. When conventionally treated abdominal surgery patients were carefully followed during "smooth recovery", they required at least 8 d before voluntary oral intake met nutritional needs with cessation of net protein and weight loss. Postoperative paralytic ileus is an avoidable complication. The patient has a prolonged requirement for parenteral fluids and medications. The severest postoperative misery may be the malaise attributable to gut malfunction, which alone can be devastating. Many perioperative factors (atropine premedication, anesthetics, narcotics, and visceral trauma) adversely affect gastrointestinal (GI) function. Nonetheless, postoperative GI function immediately begins its reappearance. Intestinal motion often is apparent during abdomen closure. In postoperative jejunal feeding, successful attempts were made both to increase the marginal function of the impaired gut and to minimize the harm caused by unrecognized overfeeding.
