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Related Experiment Videos

[Postoperative disease: evolution of the concept].

J C da Costa1

  • 1Faculdade de Medicina de Lisboa.

Acta Medica Portuguesa
|November 1, 1990
PubMed
Summary

Leriche's post-operative illness concept evolved into a metabolic view of surgery and trauma. Understanding surgery requires integrating pre-operative, per-operative, and post-operative phases for a holistic patient approach.

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Reflections.

Journal of general internal medicine·2016

Area of Science:

  • Physiology
  • Surgical Science
  • Medical History

Context:

  • René Leriche described "La Maladie post-opératoire" in 1934, a systemic surgical response beyond clinical assessment.
  • Anglo-Saxon literature initially overlooked Leriche's concept, but Harvard researchers later advanced similar ideas.
  • Walter Cannon's homeostasis and the Harvard group's "chemical anatomy" laid groundwork for viewing surgery as a metabolic issue.

Purpose:

  • To re-evaluate Leriche's "La Maladie post-opératoire" in light of modern physiological and metabolic understanding.
  • To integrate historical concepts of surgical illness with contemporary biological and physiological principles.
  • To advocate for a unified, holistic view of surgical patients, encompassing anatomical, metabolic, and psychological aspects.

Summary:

  • Francis Moore reframed surgery and trauma as metabolic problems, building on Cannon's homeostasis and fluid chemistry research.
  • Surgery is now viewed as a continuous process (pre-operative, per-operative, post-operative), inseparable from patient recovery.
  • The concept of "La Maladie post-opératoire" expanded to recognize multiple post-operative conditions and the need for a global patient assessment.

Impact:

  • Shifted surgical practice towards a metabolic and physiological understanding, moving beyond purely anatomical concerns.
  • Emphasized the interconnectedness of surgical phases and the importance of a holistic patient view.
  • Enabled surgeons to adopt a more integrated, physiologist-like approach to patient care.

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