Summary
Voluntary control of the motility of intestinal reservoirs may be used to improve evacuation and continence. In 4 dogs a U-shaped jejunum pouch and in another 4 an ileum pouch was constructed and instrumented with stimulating and EMG electrodes and pressure lines. In the acute experiments jejunum pouch stimulation with 200 μs 1.67 kHz 30 mA increased the intrapouch pressure by 38 ± 4 mm Hg (n = 6) and 500 μs 910 Hz 25 mA by 60 ± 5 mm Hg (n = 3). The pressure increase in the awake animals was consistently lower (200 μs 4±6 mm Hg,n=9; 500 μs 25±17,n= 11). The ileum pouch responded with a 37 ± 10 mm Hg pressure increase (n=9) to 50 ms 6 Hz 20 mA pulse trains. Ileum pouches could not be stimulated in the awake animal due to contraction of the abdominal wall. Electrostimulation may be used to contract and evacuate intestinal reservoirs but additional drug therapy or autonomic nerve stimulation will be necessary to lower the thresholds especially for ileum stimulation in the awake animal.
Zusammenfassung
Die Kontrolle der Motorik von intestinalen Reservoiren kann zur Verbesserung der Entleerung und der Kontinenz beitragen. Bei 4 Tieren wurde ein U-förmiger Jejunumpouch und bei weiteren 4 ein Ileumpouch gebildet und mit Stimulationselektroden und Druckkathetern instrumentiert. Die akute Stimulation des Jejunumpouches mit 30 mA 200 μs 1,67 kHz erhöhte den Innen druck um 38 ± 4 mm Hg (n = 6). Eine Stimulation mit 500 μs 910 Hz 25 mA ergab eine Druckerhöhung von 60 ± 5 mm Hg. Bei 11 Messungen an zwei chronisch instrumentierten Tieren erhöhte dieselbe Stimulation den Druck um 25 ± 17 mm Hg. Die 200 μs Kombination zeigte variable Ergebnisse. Im Ileumpouch konnte im Akutversuch mit 50 ms 6 Hz 20 mA (n = 9) der Druck um 37 ± 10 mm Hg gesteigert werden. Diese Stimulationsform wurde vom wachen Tier nicht toleriert. Eine Elektrostimulation von Dünndarmreservoiren ist prinzipiell möglich, die Variabilität der Reaktion muß durch adjuvante Pharmacotherapie oder durch Stimulation vegetativer Nerven kontrolliert werden.
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Moritz, A., Grundfest-Broniatowski, S., Ilyes, L. et al. Elektrostimulation von Ileum und Jejunumreservoiren im akuten und chronischen Experiment. Langenbecks Arch Chiv 374, 267–271 (1989). https://doi.org/10.1007/BF01261468
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DOI: https://doi.org/10.1007/BF01261468