Evaluation of the longitudinal musculature of segments of the distal colon interposed following extended jejunum-ileum resection.
Several morbid conditions may necessitate extensive intestinal resection, leading to short-bowel syndrome. When clinical treatment becomes inefficient, a surgical approach is necessary. Distal colon interposition is one of the viable techniques. The interposition of colon segments between remnants of the small bowel improved lifestyle, increased transit time, and diminished diarrhea. The aim of this study is to observe the longitudinal muscular contractions after distal colon interposition. Sixteen male Wistar rats (EPM-1) were submitted to an 80% small bowel resection associated with a partial colectomy of the distal colon immediately after the bifurcation of the middle colic artery followed by a 3-cm isoperistaltic distal colon interposition. After 70 days, the animals were submitted to euthanasia and segments of the jejunum, ileum, remnant colon, and interposed colon were prepared for pharmacological tests. The isometric contractions were measured by a polygraph. After 30 minutes, the dose/effect curves were obtained for both metacholine and barium chloride stimulation through the extraluminal surface (serosa). After this period, we observed a significant increase in the length, diameter, and thickness of the intestinal wall. Regarding the sensibility (pD(2)), no difference was found (interposed colon = 7.21 +/- 0.2; remnant colon = 7.65 +/- 0.1; remnant jejunum 7.46 +/- 0.1; and remnant ileum 7.57 +/- 0.1), even though the animals were submitted to different procedures. In relation to the maximal effect (E(max)), the longitudinal muscle contraction responses (interposed colon = 11.79 +/- 0.1; remnant jejunum = 15.42 +/- 0.2; and remnant ileum = 11.48 +/- 0.2) were lower than those of the remnant colon (E(max) = 22.42 +/- 0.1). This means that there was a possible adaptation of colonic segments to their new location.
Taha
M O
MO
Department of Surgery, Discipline of Operative Technique and Experimental Surgery, Federal University of São Paulo, Escola Paulista de Medicina, São Paulo, Brazil.
Ribeiro
M A
MA
de Oliveira Gomes
P
P
Montero Frasson
E
E
Plapler
H
H
Ferreira
R
R
Lapa
A J
AJ
Soucar
C
C
D000714:Anastomosis, Surgical; D000818:Animals; D003106:Colon / Q000502:physiology; D007082:Ileum / Q000601:surgery*; D007537:Isometric Contraction; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008866:Microsurgery; D009130:Muscle, Smooth / Q000502:physiology*; D051381:Rats; D017208:Rats, Wistar