Moon Suk-Bae, Park Kyu-Joo, Moon Jung-Sun, Choe Eun-Kyoung, So In-Suk, Jung Sung-Eun
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Apr;80(4):251-9. doi: 10.4174/jkss.2011.80.4.251. Epub 2011 Apr 12.
This study was intended to investigate the migrating motor complex (MMC) changes after ileal bypass in ex-vivo mouse models.
Partial (side-to-side) and total bypass (occlusion of proximal part of bypassed loop) were performed on ileums of female Institute of Cancer Research mice. After 2 and 4 weeks, the bypassed segments were harvested and MMCs were recorded at 4 different sites ex-vivo. Amplitude, duration, interval, direction of propagation, and the area under the curve (AUC) of MMCs were measured and compared to those of the controls.
In control mice (n = 7), most MMCs propagated aborally (91.1%). After 2 weeks of partial bypass (n = 4), there was a significant decrease in both amplitude and AUC, and orally-propagating MMCs increased significantly (45%, P = 0.002). Bidirectional MMCs (originating in the bypassed loop and propagating in both directions) were also observed (10%). The amplitude of the MMCs remained decreased at 4 weeks after partial bypass (n = 4), and neither the AUC nor the direction of propagation showed significant changes compared to 2 weeks. Similarly, in the total bypass model, both the amplitude and AUC of the MMCs decreased significantly compared to controls. In contrast to partial bypass, 95% of the MMCs within the bypassed loop propagated aborally after 2 weeks (n = 6), which was similar to the control state. After 4 weeks (n = 5), however, MMCs either lost their temporal relationship or completely disappeared.
The changes in propagation direction of the MMCs in the partially bypassed loop may contribute to stagnation of bowel contents and the development of blind loop syndrome.
本研究旨在探讨离体小鼠模型中回肠旁路术后移行性运动复合波（MMC）的变化。
对雌性癌症研究所小鼠的回肠进行部分（侧侧）旁路和完全旁路（旁路肠袢近端闭塞）手术。2周和4周后，采集旁路肠段，在离体状态下于4个不同部位记录MMC。测量MMC的振幅、持续时间、间隔、传播方向和曲线下面积（AUC），并与对照组进行比较。
在对照小鼠（n = 7）中，大多数MMC向口端传播（91.1%）。部分旁路术后2周（n = 4），振幅和AUC均显著降低，向口端传播的MMC显著增加（45%，P = 0.002）。还观察到双向MMC（起源于旁路肠袢并向两个方向传播）（10%）。部分旁路术后4周（n = 4），MMC的振幅仍降低，与2周相比，AUC和传播方向均无显著变化。同样，在完全旁路模型中，与对照组相比，MMC的振幅和AUC均显著降低。与部分旁路不同的是，旁路肠袢内95%的MMC在2周后（n = 6）向口端传播，这与对照状态相似。然而，4周后（n = 5），MMC要么失去其时间关系，要么完全消失。
部分旁路肠袢中MMC传播方向的改变可能导致肠内容物停滞和盲袢综合征的发生。
