Uchiyama M, Iwafuchi M, Naitoh S, Matsuda Y, Naitoh M, Yagi M, Ohtani S
Department of Pediatric Surgery, Niigata University School of Medicine.
J Smooth Muscle Res. 1995 Jun;31(3):109-18. doi: 10.1540/jsmr.31.109.
To evaluate intestinal motility after 80% massive distal small bowel resection (MSBR), we continuously monitored interdigestive and postprandial bowel motility using bipolar electrodes and/or contractile strain gage force transducers in conscious beagle dogs before, and at 0-4 weeks and 8-13 months after the surgery. Fasting duodenal migrating myoelectric (or motor) complexes (MMCs) occurred at longer intervals in the short-term after 80% MSBR than in controls, and were simulated in long-term that in controls. MMCs arising from the duodenum were often migrated to the proximal jejunum, the jejunum above the anastomosis, and to the terminal ileum beyond the anastomosis. The velocity of duodenal MMC propagation was slowed in every intestinal segment in the short-term, and had not recovered even long after the operation. The duration of the postprandial period without duodenal MMCs was prolonged significantly in the short-term, and still remained longer in the long-term than in controls. These findings suggest that changes in gut motility after MSBR tend to compensate for the shorter intestine and maintain small bowel absorption early postoperatively, and adaptations of motility would occur over the long-term to increased intestinal absorption.
为评估80%远端小肠大部切除术后(MSBR)的肠道运动,我们在清醒的比格犬术前、术后0 - 4周及8 - 13个月,使用双极电极和/或收缩应变计力传感器连续监测消化间期和餐后肠道运动。80% MSBR术后短期内,空腹十二指肠移行性肌电(或运动)复合波(MMCs)的出现间隔比对照组更长,长期来看则与对照组相似。源自十二指肠的MMCs常迁移至空肠近端、吻合口上方的空肠以及吻合口远端的回肠末端。短期内,十二指肠MMC传播速度在每个肠段均减慢,术后很长时间仍未恢复。餐后无十二指肠MMCs的持续时间在短期内显著延长,长期来看仍比对照组更长。这些发现表明,MSBR术后肠道运动的变化倾向于补偿小肠缩短并在术后早期维持小肠吸收,且长期来看运动会适应增加的肠道吸收。