Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, 1142, Auckland, New Zealand.
Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Biomed Eng Online. 2021 Oct 16;20(1):105. doi: 10.1186/s12938-021-00944-x.
Cyclic motor patterns (CMP) are the predominant motor pattern in the distal colon, and are important in both health and disease. Their origin, mechanism and relation to bioelectrical slow-waves remain incompletely understood. During abdominal surgery, an increase in the CMP occurs in the distal colon. This study aimed to evaluate the feasibility of detecting propagating slow waves and spike waves in the distal human colon through intraoperative, high-resolution (HR), serosal electrical mapping.
HR electrical recordings were obtained from the distal colon using validated flexible PCB arrays (6 × 16 electrodes; 4 mm inter-electrode spacing; 2.4 cm, 0.3 mm diameter) for up to 15 min. Passive unipolar signals were obtained and analysed.
Eleven patients (33-71 years; 6 females) undergoing colorectal surgery under general anaesthesia (4 with epidurals) were recruited. After artefact removal and comprehensive manual and automated analytics, events consistent with regular propagating activity between 2 and 6 cpm were not identified in any patient. Intermittent clusters of spike-like activities lasting 10-180 s with frequencies of each cluster ranging between 24 and 42 cpm, and an average amplitude of 0.54 ± 0.37 mV were recorded.
Intraoperative colonic serosal mapping in humans is feasible, but unlike in the stomach and small bowel, revealed no regular propagating electrical activity. Although sporadic, synchronous spike-wave events were identifiable. Alternative techniques are required to characterise the mechanisms underlying the hyperactive CMP observed in the intra- and post-operative period.
The aim of this study was to assess the feasibility of detecting propagating electrical activity that may correlate to the cyclic motor pattern in the distal human colon through intraoperative, high-resolution, serosal electrical mapping. High-resolution electrical mapping of the human colon revealed no regular propagating activity, but does reveal sporadic spike-wave events. These findings indicate that further research into appropriate techniques is required to identify the mechanism of hyperactive cyclic motor pattern observed in the intra- and post-operative period in humans.
循环运动模式（CMP）是远端结肠的主要运动模式，在健康和疾病中都很重要。其起源、机制及其与生物电慢波的关系仍不完全清楚。在腹部手术过程中，远端结肠的 CMP 会增加。本研究旨在评估通过术中高分辨率（HR）、浆膜电描记术检测人类远端结肠传播慢波和尖峰波的可行性。
使用经过验证的柔性 PCB 阵列（6×16 个电极；电极间距 4mm；直径 2.4cm、0.3mm）对远端结肠进行 HR 电记录，最长可达 15min。获取并分析被动单极信号。
共纳入 11 名接受全身麻醉下结直肠手术的患者（4 名合并硬膜外麻醉）（33-71 岁；6 名女性）。在去除伪影并进行全面的手动和自动分析后，在任何患者中均未发现频率在 2-6cpm 之间的规则传播活动。记录到间歇性的尖峰样活动簇，持续 10-180s，每个簇的频率在 24-42cpm 之间，平均幅度为 0.54±0.37mV。
在人类中进行术中结肠浆膜描记是可行的，但与胃和小肠不同，没有发现规则的传播电活动。虽然偶有发生，但可识别同步的尖峰波事件。需要替代技术来描述在围手术期观察到的过度活跃的 CMP 背后的机制。
本研究旨在评估通过术中高分辨率、浆膜电描记术检测可能与人类远端结肠的 CMP 相关的传播电活动的可行性。人类结肠的高分辨率电描记图未显示出规则的传播活动，但确实显示出偶发性的尖峰波事件。这些发现表明，需要进一步研究适当的技术来确定在人类围手术期观察到的过度活跃的循环运动模式的机制。
