Postoperative gastric drainage: Quantitative study for an indication of re-establishment of gastro-intestinal motility following gastric operations

Abstract

G ASTRIC surgery, which until late in the nineteenth century was undertaken with certain misgivings, has increased in prevaIence in recent years. This has been due not only to refinements in surgica1 technic but also to the improved methods in postoperative care that have led to a more favorabIe outcome. Continuous or intermittent suction appbed to a tube passed through the nose or mouth into the stomach is an fntegra1 part of such care. Since the stomach tube was popuIarized over a hundred years ago, there have been introduced a Iarge and varied assortment of tubes for emptying the stomach. The Levine tube has perhaps met with the greatest favor. Likewise, numerous methods of applying suction to such a tube have been suggested. Of these the principIe advanced by Wangensteen is as simple and effectua1 as any. Postoperative intubation is advisabIe, following gastric operations, to protect suture lines against stress, to permit the patient to take water and other fluids after recovery from anesthesia, to prevent overdistention of the stomach with Iiquid and gas, and to rest the stomach unti1 IocaI edema and irritation have subsided. RegardIess of the genera1 condition of the patient, secondary edema wiI1 appear at the site of the operation and may delay gastric emptying for severa days. Edema occasionally deveIops as a resuJt of disordered body metaboIism. The overdistention that is observed may be due to any factor retarding gastric emptying time. It may arise from edema at the pylorus or around a newIy formed MASSACHUSETTS