Magnitude of abdominal incision affects the duration of postoperative ileus in rats.
BACKGROUND
The pathogenesis of reduced postoperative ileus (POI) in laparoscopic gastrointestinal (GI) surgery still remains controversial. The aim of this study was to investigate the effect of surgical incision on postoperative ileus.


METHODS
The effects of length, depth, and site of the incision on GI transit were compared using the geometric center of 51Cr in rats. The inhibitory mechanism of abdominal incision on GI transit also was studied.


RESULTS
The findings showed that 5 cm of abdominal skin and the 5-cm back muscle incision had no significant effect on GI transit. However, the 5-cm abdominal muscle-fascia incision and a 5-cm laparotomy significantly delayed GI transit. Gastrointestinal transit after a 5-cm laparotomy was significantly delayed, as compared with that of a 1-cm laparotomy regardless whether intestinal manipulation was performed or not. Guanethidine and yohimbine, but not propranolol, significantly improved the impaired GI transit after a 5-cm laparotomy.


CONCLUSIONS
The results suggest that the longer and deeper abdominal incision more profoundly inhibits GI transit. The inhibitory effect of abdominal incision is mediated via the activation of the somatosympathetic reflex and alpha-2 adrenoceptors.
Uemura
K
K
Department of Surgery, Veterans Affairs Medical Center and Duke University Medical Center, 508 Fulton Street, Durham, NC 27705, USA.
Tatewaki
M
M
Harris
M B
MB
Ueno
T
T
Mantyh
C R
CR
Pappas
T N
TN
Takahashi
T
T
D000007:Abdominal Injuries / Q000150:complications; D034861:Abdominal Wall; D058669:Adrenergic alpha-2 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000818:Animals; D002860:Chromium Radioisotopes; D005205:Fascia / Q000293:injuries; D005772:Gastrointestinal Transit / Q000187:drug effects; D006145:Guanethidine / Q000494:pharmacology / Q000627:therapeutic use; D045823:Ileus / Q000209:etiology / Q000517:prevention & control*; D007813:Laparotomy / Q000379:methods*; D008297:Male; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control*; D011433:Propranolol / Q000494:pharmacology; D019275:Radiopharmaceuticals; D051381:Rats; D017207:Rats, Sprague-Dawley; D018341:Receptors, Adrenergic, alpha-2 / Q000502:physiology*; D012018:Reflex / Q000187:drug effects; D012867:Skin / Q000293:injuries; D013564:Sympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology; D013997:Time Factors; D015016:Yohimbine / Q000494:pharmacology / Q000627:therapeutic use
D058669:Adrenergic alpha-2 Receptor Antagonists; D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D002860:Chromium Radioisotopes; D019275:Radiopharmaceuticals; D018341:Receptors, Adrenergic, alpha-2; D015016:Yohimbine; D011433:Propranolol; D006145:Guanethidine