Neri Flavia, Cavallari Giuseppe, Tsivian Matvey, Bianchi Elisa, Aldini Rita, Cevenini Monica, Guidetti Elena, Piras Gian Luca, Pariali Milena, Nardo Bruno
Department of General Surgery and Transplantation, S. Orsola-Malpighi Hospital, University of Bologna, 40126 Bologna, Italy.
J Biomed Biotechnol. 2012;2012:896162. doi: 10.1155/2012/896162. Epub 2012 May 8.
Medical treatment in chronic constipation is not always successful. Surgery is indicated in unresponsive selected severe cases. This study presents the distal venous colic ligation in rat as a novel surgical approach.
16 rats (study group) were evaluated in 3 phases of 6 days each: A (normal conditions), B (loperamide-induced constipation), and C (colic vein legation) and compared with rats treated in phase C with PEG 4,000 (control group). Blood biochemical and physiological parameters, daily fecal water content (FWC), and histological analysis were performed in all study phases.
No biochemical and physiological parameters changes were observed. FWC decreased in phase B and increased in phase C in both groups with a grow up to 2.3-fold in study group compared to control (P < 0.0001). Moreover, in study group, a high number of colonic goblet cells were detected (phase C versus phase B: P < 0.001) while no differences were registered in control.
By ligature of the colic vein in constipated rats, an increase in FWC and goblet cells higher than in PEG treated rats was detected. The described surgical procedure appeared effective, simple, and safe; further studies in animal models, however, are necessary to assess its clinical applicability.
慢性便秘的医学治疗并非总是成功的。对于选定的难治性重症病例，需进行手术治疗。本研究提出了一种新型手术方法——大鼠结肠静脉远端结扎术。
对16只大鼠（研究组）进行了3个阶段的评估，每个阶段为期6天：A阶段（正常状态）、B阶段（洛哌丁胺诱导的便秘）和C阶段（结肠静脉结扎），并与在C阶段接受聚乙二醇4000治疗的大鼠（对照组）进行比较。在所有研究阶段均进行了血液生化和生理参数、每日粪便含水量（FWC）及组织学分析。
未观察到生化和生理参数的变化。两组在B阶段FWC均下降，在C阶段均上升，研究组相较于对照组增长达2.3倍（P < 0.0001）。此外，研究组检测到大量结肠杯状细胞（C阶段与B阶段相比：P < 0.001），而对照组未发现差异。
通过结扎便秘大鼠的结肠静脉，发现其FWC和杯状细胞的增加高于聚乙二醇治疗的大鼠。所述手术方法似乎有效、简单且安全；然而，需要在动物模型中进行进一步研究以评估其临床适用性。
