Background
Anterior resection for rectal disease is associated with extrinsic autonomic denervation
of the neorectum, which may influence the myenteric plexus, and subsequently the motility/defecatory
status after operation.
Methods
A rat model with denervated neorectum was constructed. Colonic contractile activity
in vivo, the amount of generic neuron marker (PGP 9.5) and nitric oxide synthase (NOS)
were measured periodically. The responses of the muscle strip in each period to electrical
field stimulation were evaluated using various neurotransmitters.
Results
In rats with denervated neorectum, giant migrating contractions (GMCs) of the distal
colon, the number of fecal lumps per day and their small size, significantly increased
in the early phase postoperatively, although both recovered in the late-phase period.
The contractile response of the muscle strip of the denervated colon to acetylcholine
was reduced throughout the period; however, contraction of the denervated colon under
the addition of NO inhibitor (l-NAME) was enhanced significantly in the late-phase period, and recovered to the control
level by atropine. Neuronal NOS, but not PGP 9.5 concentration, in the myenteric plexus
at the distal denervated colon, significantly increased in the late-phase period.
None of the above items differed from the control at other colonic portions throughout
the period.
Conclusions
Extrinsic autonomic denervation causes abnormal hyper-motility in the neorectum, which
may be associated with multiple evacuations in the early phase postoperatively. Increased
acetylcholine and the subsequent increase of neuronal NOS in the myenteric plexus
may be an adaptive mechanism to compensate for such abnormal colonic motility after
extrinsic denervation.
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Article info
Publication history
Accepted:
August 31,
2005
Footnotes
Supported by a Grant-in-Aid for Scientific Research from the Japanese Ministry of Education (115591376) and a Grant-in-Aid from the Japanese Ministry of Health, Labor, and Welfare (14-13).
Identification
Copyright
© 2006 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
