Nguyen B L, Thompson J S, Quigley E M
Department of Surgery, Omaha VAMC, Nebraska 68198-3280, USA.
J Surg Res. 1996 Feb 15;61(1):147-51. doi: 10.1006/jsre.1996.0096.
The response of intestinal muscle to resection has received less attention than mucosal adaptation but may be important in relation to altered motility and improved intestinal absorption. Our aim was to determine the effect of extent of resection on intestinal muscle adaptation. Distal resections of 25% (n = 5), 50% (n = 5), and 75% (n = 5) of the intestine were performed. Transverse intestinal sections were taken at resection and 12 weeks later to evaluate changes in mucosa and circular and longitudinal muscle thickness. Muscle cell number and size and muscle length were also measured. Mucosal thickness increased (P < 0.05) after all resections, (1007 +/- 253 microns vs 1259 +/- 181 microns, 25%; 1019 +/- 191 microns vs 1366 +/- 293 microns, 50%; and 927 +/- 88 microns vs 1432 +/- 213 microns, 75%). Longitudinal muscle thickness (169 +/- 35 microns vs 254 +/- 45 microns, 50%; 207 +/- 71 microns vs 353 +/- 103 microns, 75%) and length (180 +/- 10 cm vs 203 +/- 16 cm, 50%; 90 +/- 16 cm vs 110 +/- 21 cm, 75%) increased (P < 0.05) following 50% and 75% resections but not after a 25% resection. Circular muscle length increased after 75% resection alone (4.4 +/- 0.2 cm vs 5.8 +/- 0.4 cm, P < 0.05). There was no significant change in circular muscle thickness after any resection. Muscle cell size and number per unit area were unchanged in all groups. We concluded that: (1) Intestinal muscle adapts after intestinal resection and this response is related to the extent of resection; in contrast, mucosal adaptation was evident following even the least extensive resection. (2) Increased thickness and length of the longitudinal muscle layer are the most prominent changes. (3) This increased muscle thickness results from hyperplasia rather than hypertrophy.
与黏膜适应性相比，肠道肌肉对切除的反应受到的关注较少，但这可能与肠道蠕动改变及肠道吸收改善有关。我们的目的是确定切除范围对肠道肌肉适应性的影响。分别进行了25%（n = 5）、50%（n = 5）和75%（n = 5）的远端肠道切除。在切除时及12周后取肠道横切片，以评估黏膜以及环形肌和纵行肌厚度的变化。还测量了肌细胞数量、大小及肌肉长度。所有切除术后黏膜厚度均增加（P < 0.05）（25%切除组：1007±253微米 vs 1259±181微米；50%切除组：1019±191微米 vs 1366±293微米；75%切除组：927±88微米 vs 1432±213微米）。50%和75%切除术后纵行肌厚度（50%切除组：169±35微米 vs 254±45微米；75%切除组：207±71微米 vs 353±103微米）和长度（50%切除组：180±10厘米 vs 203±16厘米；75%切除组：90±16厘米 vs 110±21厘米）增加（P < 0.05），但25%切除术后未增加。仅75%切除术后环形肌长度增加（4.4±0.2厘米 vs 5.8±0.4厘米，P < 0.05）。任何切除术后环形肌厚度均无显著变化。所有组中单位面积内的肌细胞大小和数量均无变化。我们得出结论：（1）肠道切除术后肠道肌肉会发生适应性变化，且这种反应与切除范围有关；相比之下，即使是最轻微的切除术后黏膜适应性也很明显。（2）纵行肌层厚度和长度增加是最显著的变化。（3）这种肌肉厚度增加是由增生而非肥大导致的。
