TY - JOUR
T1 - Surgical autonomic denervation results in altered colonic motility
T2 - an explanation for low anterior resection syndrome?
AU - Lee, Woo Yong
AU - Takahashi, Toku
AU - Pappas, Theodore
AU - Mantyh, Christopher R.
AU - Ludwig, Kirk A.
PY - 2008/6
Y1 - 2008/6
N2 - Background: We hypothesized that the bowel dysfunction known as low anterior resection syndrome is caused by denervation of the left colon. The purpose of this study is to determine how surgical denervation changes left colon motility and to identify the mechanism of this change. Materials and methods: Strain gauge transducers were implanted on the serosal surface of the descending colon of male SD rats (250-300 g). After a 2-h baseline recording, motility was recorded for another 2 h after either simple left colon manipulation (n = 6) or surgical left colon denervation (n = 6). Various pharmacologic agents were then administered before denervation to determine the mechanism by which denervation changed left colon motility. Changes in motility were calculated by determining a % motility index (MI) (%MI = MI posttreatment/MI baseline) with significance defined as P < .05. Result: Denervation resulted in an increased mean %MI (128.8 ± 15.4) compared with simple manipulation of the bowel, which decreased mean %MI (87.9 ± 25.3) (P < .05). In the second set of experiments, both guanethidine and phentolamine increased mean %MI after injection (P < .05), but no additional increase of %MI occurred after denervation (P < .05). However, propranolol produced no increase of motility after injection and it did not affect the increase in motility observed after denervation (P < .05). Conclusion: Surgical denervation of the left colon results in a significant increase in motility. Pharmacologically, this increase seems to be the result of destruction of an inhibitory α-sympathetic pathway. This increased motility may contribute to low anterior resection syndrome.
AB - Background: We hypothesized that the bowel dysfunction known as low anterior resection syndrome is caused by denervation of the left colon. The purpose of this study is to determine how surgical denervation changes left colon motility and to identify the mechanism of this change. Materials and methods: Strain gauge transducers were implanted on the serosal surface of the descending colon of male SD rats (250-300 g). After a 2-h baseline recording, motility was recorded for another 2 h after either simple left colon manipulation (n = 6) or surgical left colon denervation (n = 6). Various pharmacologic agents were then administered before denervation to determine the mechanism by which denervation changed left colon motility. Changes in motility were calculated by determining a % motility index (MI) (%MI = MI posttreatment/MI baseline) with significance defined as P < .05. Result: Denervation resulted in an increased mean %MI (128.8 ± 15.4) compared with simple manipulation of the bowel, which decreased mean %MI (87.9 ± 25.3) (P < .05). In the second set of experiments, both guanethidine and phentolamine increased mean %MI after injection (P < .05), but no additional increase of %MI occurred after denervation (P < .05). However, propranolol produced no increase of motility after injection and it did not affect the increase in motility observed after denervation (P < .05). Conclusion: Surgical denervation of the left colon results in a significant increase in motility. Pharmacologically, this increase seems to be the result of destruction of an inhibitory α-sympathetic pathway. This increased motility may contribute to low anterior resection syndrome.
UR - https://www.scopus.com/pages/publications/44749093603
U2 - 10.1016/j.surg.2008.03.014
DO - 10.1016/j.surg.2008.03.014
M3 - Article
C2 - 18549894
AN - SCOPUS:44749093603
SN - 0039-6060
VL - 143
SP - 778
EP - 783
JO - Surgery
JF - Surgery
IS - 6
ER -