title: Role of the enteric nervous system in the elongated sigmoid colon of patients with sigmoid volvulus.
abstract: To clarify the physiologic function of the enteric nervous system (ENS) in the elongated sigmoid colon (ESC) of patients with sigmoid volvulus (SV), we examined the enteric nerve responses in lesional and normal longitudinal muscle strips (LMS) derived from patients with ESC and patients who underwent colon resection for colonic cancers. Thirty preparations of LMS were taken from the lesional sigmoid colons of 10 ESC patients with SV (8 men and 2 women, aged 53 to 80 years, mean 66.2 years). Forty preparations of LMS were taken from the normal sigmoid colons (NSC) of 20 patients with colonic cancer (12 men and 8 women, aged 55 to 76 years, mean 62.3 years). A mechanographic technique was used to evaluate in vitro muscle responses to electrical field stimulation (EFS) before and after treatment with various autonomic nerve blockers. Response to EFS before blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction rather than contraction reaction (P = 0.0253, P < 0.0001, respectively). ESC showed relaxation reaction more than NSC (P = 0.1138). Response to EFS after blockade of the adrenergic and cholinergic nerves was as follows: NSC and ESC significantly demonstrated relaxation reaction via nonadrenergic noncholinergic (NANC) inhibitory nerves rather than contraction reaction via NANC excitatory nerves (P < 0.0001, P < 0.0001, respectively). ESC with SV significantly showed relaxation reaction more than NSC (P = 0.0092). An increased response of relaxation mediated NANC inhibitory nerves may play a role in impaired motility in the ESC of patients with SV.
authors.affiliation: 1 Department of Surgery, Nippon Dental University Hospital at Tokyo, Japan.
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Tomita
authors.forename: Kiminobu
authors.initials: K
authors.lastname: Sugitou
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sakurai
authors.forename: Shigeru
authors.initials: S
authors.lastname: Fujisaki
authors.forename: Taro
authors.initials: T
authors.lastname: Ikeda
authors.forename: Tsugumichi
authors.initials: T
authors.lastname: Koshinaga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D012809:Colon, Sigmoid / Q000294:innervation*; D003110:Colonic Neoplasms / Q000601:surgery; D004558:Electric Stimulation; D017615:Enteric Nervous System / Q000502:physiology*; D005260:Female; D006801:Humans; D045822:Intestinal Volvulus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009407:Nerve Block / Q000379:methods
keywords: Elongated sigmoid colon; Enteric nervous system; Nonadrenergic noncholinergic inhibitory nerve; Pathophysiology; Sigmoid volvulus