Irie M, Kajiyama Y, Enjoji A, Ozeki K, Ura K, Kanematsu T
Department of Surgery II, Nagasaki University School of Medicine, Sakamoto, Japan.
Surg Today. 1998;28(6):626-32. doi: 10.1007/s005950050195.
In a curative resection for advanced sigmoid or rectal cancer, an extensive dissection of the regional lymph nodes is generally required. This often necessitates the removal of the autonomic nerves around the inferior mesenteric artery. The present study was done in an attempt to clarify the influence of a neurectomy around the inferior mesenteric ganglion and plexus on the motility of the colon. In eight dogs, we resected the ganglion and plexus around the inferior mesenteric artery, together with an implantation of strain gauge force transducers in various parts of the colon, and 7-10 days later, colonic motility was examined. The percentage of contractile states and contractile forces increased at both the distal colon in fasting dogs, as well as at the middle colon in the late postprandial period. At the distal colon, contractile forces were noted in the early and late postprandial periods. These contractile abnormalities at the middle and distal colon may thus explain the frequent bowel movements or diarrhea often observed after extensive surgery in patients with sigmoid or rectal cancer.
在对晚期乙状结肠或直肠癌进行根治性切除时，通常需要对区域淋巴结进行广泛清扫。这往往需要切除肠系膜下动脉周围的自主神经。本研究旨在阐明肠系膜下神经节和神经丛切除术对结肠运动的影响。在八只狗身上，我们切除了肠系膜下动脉周围的神经节和神经丛，并在结肠的各个部位植入应变片式力传感器，7至10天后，检测结肠运动。禁食狗的远端结肠以及餐后晚期的中段结肠，收缩状态和收缩力的百分比均增加。在远端结肠，餐后早期和晚期均记录到收缩力。因此，乙状结肠或直肠癌患者广泛手术后经常出现的排便频繁或腹泻，可能与中段和远端结肠的这些收缩异常有关。
