[Postoperative digestive complications of thoracic surgery]

The authors investigated the pathologic digestive manifestations that have developed after 2000 surgical interventions in the thoracic-pulmonary field. Four categories of digestive disturbances have been considered: paresis (dynamic ileus), including acute gastric dilation; haemorrhage; mechanical ileus, and digestive perforation. The digestive pathology developed either autonomously or in association with other symptoms of shock. A total of 788 digestive complications have been recorded (39%), of which: 654 cases of dynamic ileus, 118 cases of haemorrhage, 2 cases of mechanical ileus, 4 cases of perforation and 10 cases of mixed complications. In fact haemorrhage is more frequent, haemorrhagic gastritis being found in most of the deceased patients, following prolonged postoperative evolution. The simultaneous or succesive development was noted of digestive complication and respiratory failure in a total of 126 patients (6,3% of the total number of cases investigated). Pulmonary failure became more severe after the onset of dynamic ileus, especially after acute gastric dilatation. The development of any digestive complication represented in all cases an aggravation factor, especially when accompanying respiratory failure. The decrease with time of the incidence of digestive complications, from 57% to 21,8%, is due to changes that have occured in anesthesy techniques, of which NLA appears to play the most important role.