Hyperactive cyclic motor activity in the distal colon after colonic surgery as defined by high-resolution colonic manometry

Vather, Ryash; O’Grady, Gregory; Lin, Tony; Du, Peng; Wells, Cameron I.; Rowbotham, David; Arkwright, John W.; Cheng, Leo K.; Dinning, Phil G.; Bissett, Ian P.

doi:10.1002/bjs.10808

Cited by 42 publications

(116 citation statements)

References 34 publications

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“…The mean amplitude (37.0 ± 7.6 vs 32.8 ± 11.9 mm Hg, P = .65), velocity (2.1 ± 0.1 vs 1.2 ± 0.6 cm/s, P = .10), and extent of propagation (7.3 ± 1.0 vs 6.1 ± 0.8 cm, P = .12) were also similar between ambulatory and non‐ambulatory recordings. No high‐amplitude propagating sequences (HAPS) were observed during the analyzed manometry recordings, consistent with other postoperative data . There was no apparent migration of the manometry catheter during the recordings, and studies were successfully completed without damage to the catheter or acquisition unit.…”

Section: Resultssupporting

confidence: 80%

“…B, Bland‐Altman plot comparing ambulatory and non‐ambulatory systems showing good agreement within 95% confidence limits. C & D, Hyperactive postoperative cyclic motor patterns recorded using the ambulatory and non‐ambulatory systems, respectively, showing a pronounced hyperactive motor pattern comparable to that described by Vather et al E, Overview plot of 18 h of continuous postoperative ambulatory recordings from a single patient…”

Section: Resultssupporting

confidence: 62%

“…Ambulatory manometry data were obtained during the first eight hours postoperatively for two of the three patients, with the third having recordings over days 3‐4 postoperatively. These data were analyzed and compared to previously published data from the early postoperative period from a similar cohort (n = 8) using the non‐ambulatory manometry system . Similar to recent observations published elsewhere, the distal colonic motility in the early postoperative period was dominated by hyperactive cyclic motor patterns (Figure C‐E).…”

Section: Resultsmentioning

confidence: 62%

“…High‐resolution (HR) colonic manometry is an emerging technique, enabling recordings up to the full length of the colon with sensors spaced at 1 cm intervals, yielding improved spatiotemporal detail . This novel technology has provided new insights into colonic motility in health, and in a range of motility disorders including bowel dysfunction in the early postoperative period following abdominal surgery …”

Section: Introductionmentioning

confidence: 99%

“…Previous HR colonic manometry studies have been limited by the need for a bulky non‐portable acquisition system connected to a computer for data recording and storage (Figure ). This is particularly restrictive in the postoperative setting, where patient mobilization is required as part of surgical recovery . Participants have been unable to mobilize with the catheter in situ without manually disconnecting from the acquisition system, thus limiting the duration of continuous recordings and preventing longitudinal assessment of postoperative colonic motility.…”

Section: Introductionmentioning

confidence: 99%

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Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

Wells

Paskaranandavadivel

Lin

et al. 2019

Neurogastroenterology Motil

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Background High‐resolution colonic manometry is an emerging technique that has provided new insights into the pathophysiology of functional colorectal diseases. Prior studies have been limited by bulky, non‐ambulatory acquisition systems, which have prevented mobilization during prolonged recordings. Methods A novel ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry was developed. Benchtop validation against a standard non‐ambulatory system was performed using standardized calibration metrics. Clinical feasibility studies were conducted in three patients undergoing right hemicolectomy. Results Pressure profiles obtained from benchtop testing were near‐identical using the ambulatory and the non‐ambulatory systems. Clinical studies successfully demonstrated ambulatory data capture with patients freely mobilizing postoperatively during continuous recordings of >60 hours. The occurrence (P = .56), amplitude (P = .65), velocity (P = .10), and extent (P = .12) of colonic motor patterns were similar to those obtained in non‐ambulatory studies. Conclusions A novel ambulatory system for high‐resolution colonic manometry has been developed and validated. This technique will facilitate prolonged ambulatory recordings of colonic motor activity, assisting with investigations into the role of colonic motility in disease states.

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Section: Resultssupporting

confidence: 80%

Section: Resultssupporting

confidence: 62%

Section: Resultsmentioning

confidence: 62%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

Wells

Paskaranandavadivel

Lin

et al. 2019

Neurogastroenterology Motil

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Constipation

Evans-Barns

King²,

Southwell³

et al. 2023

Pediatric Surgery

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Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

Sica,

Siragusa,

Pirozzi

et al. 2024

Int J Colorectal Dis

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Purpose Routine use of abdominal drain or prolonged antibiotic prophylaxis is no longer part of current clinical practice in colorectal surgery. Nevertheless, in patients undergoing laparoscopic right hemicolectomy with intracorporeal anastomosis (ICA), it may reduce perioperative abdominal contamination. Furthermore, in cancer patients, prolonged surgery with extensive dissection such as central vascular ligation and complete mesocolon excision with D3 lymphadenectomy (altogether radical right colectomy RRC) is called responsible for affecting postoperative ileus. The aim was to evaluate postoperative resumption of gastrointestinal functions in patients undergoing right hemicolectomy for cancer with ICA and standard D2 dissection or RRC, with or without abdominal drain and prolonged antibiotic prophylaxis. Methods Monocentric factorial parallel arm randomized pilot trial including all consecutive patients undergoing laparoscopic right hemicolectomy and ICA for cancer, in 20 months. Patients were randomized on a 1:1:1 ratio to receive abdominal drain, prolonged antibiotic prophylaxis or neither (I level), and 1:1 to receive RRC or D2 colectomy (II level). Patients were not blinded. The primary aim was the resumption of gastrointestinal functions (time to first gas and stool, time to tolerated fluids and food). Secondary aims were length of stay and complications’ rate. ClinicalTrials.gov no. NCT04977882. Results Fifty-seven patients were screened; according to sample size, 36 were randomized, 12 for each arm for postoperative management, and 18 for each arm according to surgical techniques. A difference in time to solid diet favored the group without drain or antibiotic independently from standard or RRC. Furthermore, when patients were divided with respect to surgical technique and into matched cohorts, no differences were seen for primary and secondary outcomes. Conclusion Abdominal drainage and prolonged antibiotic prophylaxis in patients undergoing right hemicolectomy for cancer with ICA seem to negatively affect the resumption of a solid diet after laparoscopic right hemicolectomy with ICA for cancer. RRC does not seem to influence gastrointestinal function recovery.

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Hyperactive cyclic motor activity in the distal colon after colonic surgery as defined by high-resolution colonic manometry

Cited by 42 publications

References 34 publications

Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

Constipation

Gastrointestinal functions after laparoscopic right colectomy with intracorporeal anastomosis: a pilot randomized clinical trial on effects of abdominal drain, prolonged antibiotic prophylaxis, and D3 lymphadenectomy with complete mesocolic excision

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