Intestinal myoelectric activity and contractile motility in dogs with a reversed jejunal segment after extensive small bowel resection.
To evaluate the functioning and effectiveness of a reversed jejunal segment after extensive small bowel resection, we continuously measured the postoperative bowel motility (using bipolar electrodes and/or contractile strain gage force transducers) in interdigestive and postprandial conscious dogs at 2 to 5 weeks after surgery. The fasting duodenal migrating myoelectric (or motor) complex (MMC) occurred at markedly longer intervals in dogs with a 20-cm reversed jejunal segment created after 75% to 80% extensive small bowel resection (group 3) than in dogs that received extensive resection alone (group 2) or dogs that underwent construction of a reversed jejunal segment without bowel resection (group 1). The MMC arising from the duodenum was often interrupted at the jejunum above the proximal anastomosis and did not migrate smoothly to the reversed segment or terminal ileum in group 3. In addition, brief small discordant contractions were frequent in the reversed segment and the jejunum above the proximal anastomosis in group 3. The duration of the postprandial period without duodenal MMC activity was significantly prolonged in groups 2 and 3. These results suggest that the transit time and passage of intestinal contents were delayed and that the periodical MMC was disturbed in group 3. The delay of transit time was due to prolongation of the interval between duodenal MMCs, the interruption of MMC propagation at the jejunum above the proximal anastomosis, the dominance of MMCs that followed the inherent anatomical continuity of the bowel, and discordant movements across the proximal anastomosis. Functional obstruction could be a potential problem in a 20-cm reversed jejunal segment inserted after extensive small bowel resection.
Uchiyama
M
M
Department of Pediatric Surgery, Niigata University Hospital, Japan.
Iwafuchi
M
M
Ohsawa
Y
Y
Yagi
M
M
Iinuma
Y
Y
Ohtani
S
S
D000714:Anastomosis, Surgical; D000818:Animals; D004285:Dogs; D004386:Duodenum / Q000502:physiology / Q000601:surgery; D004567:Electrodes, Implanted; D004576:Electromyography; D005769:Gastrointestinal Motility / Q000502:physiology*; D007421:Intestine, Small / Q000502:physiology* / Q000601:surgery; D007583:Jejunum / Q000502:physiology / Q000601:surgery*; D009119:Muscle Contraction; D016065:Myoelectric Complex, Migrating