Thompson J S, Quigley E M, Adrian T E
Surgical Service, Omaha VAMC, Nebraska, USA.
Dig Dis Sci. 1996 Sep;41(9):1760-7. doi: 10.1007/BF02088742.
Changes in motor function occur in the intestinal remnant after intestinal resection. Smooth muscle adaptation also occurs, particularly after extensive resection. The time course of these changes and their interrelationship are unclear. Our aim was to evaluate changes in canine smooth muscle structure and function during intestinal adaptation after transection and resection. Twenty-five dogs underwent either transection (N = 10), 50% distal resection (N = 10), or 50% proximal resection (N = 5). Thickness and length of the circular (CM) and longitudinal (LM) muscle layers were measured four and 12 weeks after resection. In vitro length-tension properties and response to a cholinergic agonist were studied in mid-jejunum and mid-ileum. Transection alone caused increased CM length in the jejunum proximal to the transection but did not affect LM length or muscle thickness. A 50% resection resulted in increased length of CM throughout the intestine and thickening of CM and LM near the anastomosis. Active tension of jejunal CM increased transiently four weeks after resection. Active tension in jejunal LM was decreased 12 weeks after transection and resection. Sensitivity of CM to carbachol was similar after transection and resection. It is concluded that: (1) Structural adaptation of both circular and longitudinal muscle occurs after intestinal resection. (2) This process is influenced by the site of the intestinal remnant. (3) Only minor and transient changes occur in smooth muscle function after resection. (4) Factors other than muscle adaptation are likely involved in the changes in motor function seen following massive bowel resection.
肠切除术后,残留肠段会出现运动功能的变化。平滑肌也会发生适应性改变,尤其是在广泛切除术后。这些变化的时间进程及其相互关系尚不清楚。我们的目的是评估犬肠道横断和切除术后肠道适应性过程中平滑肌结构和功能的变化。25只犬分别接受横断术(N = 10)、远端50%切除术(N = 10)或近端50%切除术(N = 5)。在切除术后4周和12周测量环形肌层(CM)和纵形肌层(LM)的厚度和长度。研究空肠中段和回肠中段的体外长度-张力特性以及对胆碱能激动剂的反应。单纯横断术使横断近端空肠的CM长度增加,但不影响LM长度或肌肉厚度。50%切除术导致整个肠道的CM长度增加以及吻合口附近的CM和LM增厚。切除术后4周,空肠CM的主动张力短暂增加。横断和切除术后12周,空肠LM的主动张力降低。横断和切除术后,CM对卡巴胆碱的敏感性相似。得出以下结论:(1)肠切除术后环形肌层和纵形肌层均会发生结构适应性改变。(2)这一过程受残留肠段部位的影响。(3)切除术后平滑肌功能仅发生轻微和短暂的变化。(4)在大规模肠切除术后出现运动功能变化的过程中,可能涉及肌肉适应性以外的其他因素。