Matsuo H
First Department of Surgery, Niigata University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1989 Apr;90(4):504-12.
Changes of intestinal myoelectric activities after total gastrectomy with jejunal interposition were studied in three conscious dogs. Under general anesthesia a total gastrectomy was performed and intestinal continuity was reestablished by a 15 cm jejunal segment interposed between the esophagus and the duodenum. Two electrodes were sown each to the serosal surface of the interposed segment of the jejunum, duodenum, and distal potion of the jejunum, respectively. After recovery from the surgery, the myoelectric activities were recorded for 8 to 12 hours during fasting and after feeding a 200 ml liquid meal. In each segment, total gastrectomy did not alter the initiation of the migrating myoelectric complex (MMC) during fasting. Total gastrectomy also changed neither the postprandial inhibition of the enteric MMC nor the induction of the fed myoelectric pattern after feeding. The way of MMC propagation along the small intestine, however, showed various patterns. Each of three segments generated its own MMCs. Some complexes migrated to the next segment or had an effect on initiating new MMCs of the next segment. Although MMCs occurring in the segment of the interposed jejunum hardly migrated to the adjacent duodenum, some jumped to the distal jejunum. These results suggest that there are no coordinated activities between the interposed jejunum and the duodenum after total gastrectomy with jejunal interposition.
在三只清醒犬身上研究了全胃切除并空肠间置术后肠道肌电活动的变化。在全身麻醉下进行全胃切除,通过在食管和十二指肠之间置入一段15厘米的空肠来重建肠道连续性。分别在置入空肠段、十二指肠和空肠远端的浆膜表面各植入两个电极。术后恢复后,在禁食期间和喂食200毫升流食后记录肌电活动8至12小时。在每个节段,全胃切除并未改变禁食期间移行性肌电复合波(MMC)的起始。全胃切除也未改变餐后肠道MMC的抑制或喂食后进食肌电模式的诱导。然而,MMC沿小肠传播的方式呈现出多种模式。三个节段中的每一个都产生自身的MMC。一些复合波迁移至下一个节段或对启动下一个节段的新MMC有影响。尽管置入空肠段中出现的MMC很少迁移至相邻的十二指肠,但一些会跳跃至空肠远端。这些结果表明,全胃切除并空肠间置术后,置入空肠与十二指肠之间不存在协调活动。