Chapelle Susan L, Bove Geoffrey M
Squamish Therapeutics, 108-41105 Tantalus Rd., Squamish, BC, Canada.
J Bodyw Mov Ther. 2013 Jan;17(1):83-8. doi: 10.1016/j.jbmt.2012.05.004. Epub 2012 Aug 12.
Abdominal surgery invariably causes a temporary reduction of normal intestinal motility, called postoperative ileus. Postoperative ileus extends hospital stays, increases the costs of hospitalization, and may contribute to the formation of postoperative adhesions. We designed experiments to determine if visceral massage affects postoperative ileus in a rat model.
Forty female Long Evans rats were assigned to 4 groups in a 2 (surgery) × 2 (treatment) factorial design. Twenty rats were subjected to a small intestinal manipulation designed to emulate "running of the bowel." Transabdominal massage was performed upon 10 operated and 10 control rats in the first 12 h following surgery. Ileus was assayed after 24 h using fecal pellet discharge and gastrointestinal transit. Intraperitoneal inflammation was assayed using total intraperitoneal protein and inflammatory cell concentrations.
The surgery consistently caused ileus. Compared to the operated group with no treatment, the operated with treatment group showed increased gastrointestinal transit and reduced time to first fecal pellet discharge. Similar group comparisons revealed that the treatment decreased total intraperitoneal protein and numbers of intraperitoneal inflammatory cells.
In this rat model, visceral massage reduced experimental postoperative ileus. The data suggest that the effect was through the attenuation of inflammation. A similar study could be designed and performed in a hospital setting to assess the potential role of visceral massage as part of the integrated care for postoperative ileus.
腹部手术总会导致正常肠道蠕动暂时减弱，即术后肠梗阻。术后肠梗阻会延长住院时间，增加住院费用，并可能促使术后粘连形成。我们设计了实验来确定内脏按摩是否会影响大鼠模型中的术后肠梗阻。
40只雌性长爪沙鼠按照2（手术）×2（治疗）析因设计分为4组。20只大鼠接受了旨在模拟“肠道蠕动”的小肠操作。在术后的前12小时，对10只手术大鼠和10只对照大鼠进行经腹按摩。24小时后，通过粪便颗粒排出和胃肠运输来检测肠梗阻情况。通过腹腔内总蛋白和炎症细胞浓度来检测腹腔内炎症。
手术始终会导致肠梗阻。与未治疗的手术组相比，接受治疗的手术组胃肠运输增加，首次粪便颗粒排出时间缩短。相似的组间比较显示，治疗降低了腹腔内总蛋白和腹腔内炎症细胞数量。
在这个大鼠模型中，内脏按摩减轻了实验性术后肠梗阻。数据表明这种作用是通过减轻炎症实现的。可以在医院环境中设计并开展类似研究，以评估内脏按摩作为术后肠梗阻综合护理一部分的潜在作用。
