Furuya Yoshitaka, Yasuhara Hiroshi, Yanagie Hironobu, Naka Shuji, Takenoue Tomohiro, Shinkawa Hiroki, Niwa Hirotaka, Kikuchi Tsuyoshi, Nagao Toshitaka
Department of Surgery, Teikyo University School of Medicine, Ichihara Hospital, 3426-3 Anesaki, Ichihara, Chiba 299-0111, Japan.
World J Surg. 2005 Jan;29(1):88-91. doi: 10.1007/s00268-004-7462-9.
The aim of this study was to clarify the role of ganglion cells in the development and recurrence of sigmoid volvulus. We analyzed 9 samples obtained from 9 patients who had undergone sigmoidectomy for sigmoid volvulus, and, for comparison, 18 samples from 18 patients who had undergone sigmoidectomy or low anterior resection for rectal cancer. Neuron-specific enolase was used for immunohistochemical staining to detect ganglion cells, and the number of ganglion cells in 20 contiguous fields was counted at 200? magnification. The average number of ganglion cells per 1000 cm(3) was corrected using the ratio of the circumference of the resected sigmoid colon to the average circumference in the control group. The raw numbers of ganglion cells in the Meissner's and Auerbach's plexuses in the volvulus group were significantly lower than those in the non-volvulus group (Meissner: p = 0.017, Auerbach: p = 0.007). The circumference of the resected sigmoid colons with volvulus was greater than that of those without volvulus (p = 0.00013). There was no significant difference in the corrected numbers of ganglion cells in the Meissner's plexus or Auerbach's plexus per 1000 cm(3) between the volvulus and non-volvulus groups (Meissner: p = 0.410, Auerbach: p = 0.890).Furthermore, there was no significant difference in the corrected numbers of ganglion cells between the revolvulus and non-revolvulus groups. These findings led us to conclude that functional disorder of bowel movement or elongation of the bowel in sigmoid volvulus or revolvulus is not related to the number of ganglion cells in Auerbach's or Meissner's plexus.
本研究的目的是阐明神经节细胞在乙状结肠扭转的发生发展及复发中的作用。我们分析了9例因乙状结肠扭转接受乙状结肠切除术患者的9份样本，并作为对照，分析了18例因直肠癌接受乙状结肠切除术或低位前切除术患者的18份样本。采用神经元特异性烯醇化酶进行免疫组织化学染色以检测神经节细胞，并在200倍放大倍数下计数20个连续视野中的神经节细胞数量。每1000 cm³神经节细胞的平均数通过切除的乙状结肠周长与对照组平均周长的比值进行校正。扭转组Meissner神经丛和Auerbach神经丛中神经节细胞的原始数量显著低于非扭转组（Meissner神经丛：p = 0.017，Auerbach神经丛：p = 0.007）。发生扭转的乙状结肠切除标本的周长大于未发生扭转的标本（p = 0.00013）。扭转组和非扭转组每1000 cm³的Meissner神经丛或Auerbach神经丛中神经节细胞的校正数量无显著差异（Meissner神经丛：p = 0.410，Auerbach神经丛：p = 0.890）。此外，扭转组和非扭转组神经节细胞的校正数量也无显著差异。这些发现使我们得出结论，乙状结肠扭转或肠扭转中肠道运动功能障碍或肠管延长与Auerbach神经丛或Meissner神经丛中神经节细胞的数量无关。
