Sigmoid myotomy

Abstract

This is an abstract of the paper read at the meeting.] nerves pharmacologically. However, the stomach and colon frequently require additional motor THE development of so-called paralytic ileus following stimulation. Therefore, by combining the use of a surgery still causes morbidity and occasional mortality. sympathetic blocking agent and a parasympatho-Experimental work has indicated that, far from mimetic drug, motility can be restored with resulting being paralysed, the small intestine is generally passage of flatus and defaecation. inhibited by sympathetic overactivity and that gutThe results in a series of patients with ileus treated motility may be restored by blocking the sympathetic by this means were presented.

Observations on the muscle abnormality of the human sigmoid colon in diverticular disease.

“…Qualitatively both drugs caused relaxation and reduced spontaneous activity in both types of muscle strip, as previously reported (Bucknell & Whitney, 1964;Fishlock & Parks, 1966). inflammatory changes are not a constant feature of the disease (Morson, 1963;Williams, 1963;Reilly 1964Reilly , 1966. Arfwiddson (1965) (b) increased motor nerve activity, (c) decreased muscle sensitivity to an inhibitory transmitter (e.g.…”

Diverticular Disease of the Colon

“…Myotomy of the sigmoid intestine in the early stages has recently been propagated as a new technique.This technique was developed by Reilly(1965Reilly( ,1966Reilly( ,1975who referred to it as longitudinal myotomy.The separation of the muscles is supposed to lead to reduction of pressure in the sigmoid colon.In the original procedure,however,only the thickened circular fibers between the taenia were separated (Akobviantz,1974;Fig.13). The method is controversial because the mortality rate lies at 5% (Parks,1974);and the intraluminal pressure reduction remains effective for only about 3 years.After that time there is a recurrence of the original condition (Smith and Ruckley,1971;Prasad and Daniel,1971)unless paraysmpatholytics and a high cellulose diet are prescribed.…”

Diverticular Disease of the Colon

“…These ideas led to important therapeutic ad vances with the use of fiber-rich foods. Sur gical treatment has also progressed with the introduction of myotomies [Reilly, 1975].…”

“…1977], This happens because the intraluminal pres sures remain high after the operation and it is advisable that the patients should con tinue with bran and spasmolytics. Sigmoid myotomy of the longitudinal muscle [Reilly, 1975] is used for poor risk patients. By this operation the intraluminal pressure is ini tially reduced but eventually symptoms re cur in the majority of the cases; usually, how ever.…”