Changes in colonic motility in dogs after a resection of the inferior mesenteric ganglion and plexus

Abstract

In a curative resection for advanced sigmoid or rectal cancer, an extensive dissection of the regional lymph nodes is generally required. This often necessitates the removal of the autonomic nerves around the inferior mesenteric artery. The present study was done in an attempt to clarify the influence of a neurectomy around the inferior mesenteric ganglion and plexus on the motility of the colon. In eight dogs, we resected the ganglion and plexus around the inferior mesenteric artery, together with an implantation of strain gauge force transducers in various parts of the colon, and 7-10 days later, colonic motility was examined. The percentage of contractile states and contractile forces increased at both the distal colon in fasting dogs, as well as at the middle colon in the late postprandial period. At the distal colon, contractile forces were noted in the early and late postprandial periods. These contractile abnormalities at the middle and distal colon may thus explain the frequent bowel movements or diarrhea often observed after extensive surgery in patients with sigmoid or rectal cancer.

A prospective case control study of functional outcomes and related quality of life after colectomy for neoplasia

“…It has been proposed that high ligation of the inferior mesenteric artery at left hemicolectomy can lead to damage of the lower mesenteric ganglion [18–20], increased colonic motility and diarrhoea [21]. Loss of the ileocaecal valve [22] and excision of the right colon [23] may lead to bile acid malabsorption, increased motility, mucus secretion and stimulation of defecation [24].…”

Effects of extrinsic autonomic denervation and myenteric plexus transection on colonic motility in conscious dogs

“…27,28 Selective severance of extrinsic nerves altered only the regularity of colonic contractile activity. [29][30][31][32] Construction of a diverted total colonic loop with interruption of only luminal continuity failed to change the interdigestive colonic contractile activity in dogs. 9 Shibata et al 33 isolation and extrinsic denervation did not affect regular colonic contractile activity.…”

Anorectal Function Problems After Left Hemicolectomy

“…In the pathophysiology of this problem, reduction of the anal resting pressure, coinciding with insertion of the circular stapler, is of crucial importance, suggesting a direct injury to the internal anal sphincter. 7,8,25,26 Colorectal surgeons agree that postoperative sphincter function is often damaged; but in the case of a high colorectal anastomosis, as carried out by us after left hemicolectomy, damage is likely to be transient. In fact, the cases of AI we observed were transient events: no patient reported having AI one year after left hemicolectomy.…”