Return of interdigestive motor complex after abdominal surgery

Abstract

Gastrointestinal mechanical activity was studied in 13 patients after different surgical procedures in a fasted and fed state and after pharmacological stimulation. Mechanical activity was recorded by means of a multi-pressure sensor probe placed intraoperatively into the jejunum. Abdominal surgery abolished normal motility only for a short period of time. The time for the reappearance of regular recurring activity fronts varied with the type of the surgical procedure from 3 hr after cholecystectomy to the sixth postoperative day after colon resection. The fed pattern occurred after the first postoperative interdigestive motor complex in all experiments. Stimulation was observed with ceruletide, which induced contractile activity in the small intestine during postoperative ileus. No coordinated caudad propagating activity was observed. The postoperative interdigestive motor complex did not correlate in time with the first passage of flatus and stool in our patients. Thus, the restoration of motility in the small intestine did not coincide with the clinical relief from the so-called "physiological" postoperative ileus.

Intraabdominal humidity and electromyographic activity of the gastrointestinal tract

“…These data indicate that laparoscopic operations proceed with minor operative trauma. Alterations of gastrointestinal electromyographic activity during and after open surgery in dogs and humans correlated with the intensity of operative trauma [8,11,13,14]. The purpose of our study was to compare the operative trauma of identical laparoscopic and conventional operations by analysis of perioperative electromyographic activity of the gastrointestinal tract.…”

Gastric Phase 3 Motility After Pylorus-Preserving Pancreatoduodenectomy

“…4,5 Some previous reports showed that although gastrointestinal phase 3 returned immediately after cholecystectomy, colectomy impaired phase 3 for 4 to 6 days. 4,5 On the other hand, we previously reported that the mean period until recovery of gastric phase 3 after pylorus-preserving pancreatoduodenectomy (PPPD) was 30 to 40 days. 6 -8 One possible explanation for the delayed recovery of gastric phase 3 after PPPD is considered to be the low plasma motilin concentrations caused by resection of the duodenum.…”

“…9 The gastrointestinal MMC disappears immediately after feeding, and the fed pattern, characterized by intermittent, irregular contractions like phase 2, starts and lasts for several hours. 9 Although recovery of phase 3 after abdominal surgery is often used to evaluate postoperative gastrointestinal activity, 4,5 whether recovery of the fasting gastrointestinal motor pattern would also predict recovery of fed-state motor activity has not been documented. Even in the field of PPPD, there have been no reports describing the relationship between the recovery of gastric phase 3 during fasting and fed-state gastric motor activity.…”

Postoperative Ileus: Pathophysiology and Treatment

“…Benson et al (1994) have shown that MMCs are present in the small bowel within a few hours after surgery. On the contrary, others investigators found that MMCs were abolished for 1 or 2 days after surgery, taking from 3 to 7 days for normal pattern to reestablish (Smith et al, 1977;Morris et al, 1983;Schippers et al, 1991). Several mechanisms are thought to play a role in POI, including sympathetic neural reflexes, local and systemic inflammatory mediators, and changes in various neural and hormonal transmitters.…”