J.Jpn. Surg. Soc.. 62(8): 799-816, 1961

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STUDY ON THE RECOVERING PROCESS OF FUNCTIONS IN THE POST-OPERATIVE DIGESTIVE ORGANS

The author studied on the recovering process of functions in the digestive organs after operation at the digestive tract from the points of digestion, absorption, secretion and movement.
So that, the author established the post-operative reasonable feeding method at the total gastrectomy and it combined with resection of the pancreas and with splenectomy, based upon four standpoints above mentioned.
1) The author studied the digestive and absorptive functions after operation in the digestive canal taking use of ratio method by chromic oxicide and radioactive isotope tracer method. These functions have rapidly recovered to normal level after the following operations ; resection of the stomach, cardiac portion of the stomach, ileocecal resection and colectomy.
On the contrary, recoveries after total gastrectomy and it combined with resection of the pancreas and with splenectomy are very slow.
Moreover, the post-operative absorption rate has not reached to normal level but only kept a constant absorption rate (about 70% in protein and 50~60% in fat).
The state of absorbability by use of isotope showes similar tendency. Disturbance of digestive and absorptive function in carbohydrate and ³²P is slight.
2) Viewing from the point of secretion in the digestive organs high unit active pancreatic juice has been observed in spite of this volume is little than normal, and this abnormal reaction has continued several days after total gastrectomy.
By intake of fluid postoperatively, the high activity of this juice does not fall so much against the volume of one is increases.
The strength at the anastomosis region in the resection of the stomach and total gastrectomy is weakest after the postoperative 3rd day and recovery of strength in the former is faster than the latter.
This means the having of serosa acts an important part.
3) On the movement of the intestine, when compared with resection of the stomach and ileocecal resection, the normal peristalsis of the colon is seen a few days later in both, but recovery of movement of the small intestine so far delays complete peristalsis is seen behind a week.
4) Early postoperative feeding has to enforce considering above-mentioned points.
That is the useful digestion and absorption in protein and fat cannot observe in several days after operation such as total gastrectomy etc., so the feeding as protein and fat into the digestive canals is not received from the point of digestion and absorption. On the point of secretion, feeding in the tracts during several days is not so good, too.
Many loss has been observed in urine although a lot of aminoacid solutions were injeceted subcutane ously or intravenously, but turning in favour of nitrogen balance had not been expected in the patients performed to total gastrectomy.
The author arrived at a conclusion, as a consequence of many clinical experiments, that the feeding in the small intestine by aminoacid mixture in form of powder acompany with testosterone injection produces good results from the points of nitrogen balance and reduction of weight of body after total gastrectomy and it combined with resection of the pancreas and with splenectomy.
(Author's abstract)

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