Digestive Diseases and Sciences

, Volume 41, Issue 4, pp 705–710 | Cite as

Recovery of gastrointestinal motility following open versus laparoscopic colon resection in dogs

  • Masayuki Hotokezaka
  • Matthew J. Combs
  • Bruce D. Schirmer
Motility, Nerve-Gut Interactions, Hormones, and Receptors

Abstract

The recovery of gastrointestinal motility was compared in dogs undergoing either laparoscopic or open sigmoidectomy. During surgery, bipolar recording electrodes were placed on the proximal and distal antrum, mid- and distal colon, and the rectum. Fasting myoelectric data were recorded postoperatively. Scintigraphic gastric emptying studies employing a solid test meal were performed before and after [postoperative day (POD) 2] operation. Ten radiopaque markers were given just before operation and retained markers were counted daily by abdominal x-ray. Gastric emptying on POD 2 was significantly delayed in the open group at 120 min compared with preoperative studies for the open group and compared with the laparoscopic group on POD 2 (P<0.05 andP<0.01, respectively). A significant difference in the number of retained markers was observed between the groups on POD 4 (P<0.05). There were no significant differences in slow-wave frequency, presence of dysrhythmias in the proximal and distal antrum, or presence of either discrete or continuous electrical response activity in the colon and rectum between groups on any days. We conclude that using a laparoscopic approach results in more rapid recovery of fed-state gastrointestinal motility following colon resection. These data also suggest that myoelectric activity alone is not a sensitive enough parameter to detect these differences in recovery in this animal model.

Key Words

laparoscopy colectomy ileus laparotomy gastric emptying 

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References

  1. 1.
    Macintyre IM, Wilson RG: Laparoscopic cholecystectomy. Br J Surg 552–559, 1993Google Scholar
  2. 2.
    The Southern Surgeons Club: A prospective analysis of 1518 laparoscopic cholecystectomies. N Engl J Med 324:1073–1078. 1991Google Scholar
  3. 3.
    Schirmer BD, Dix J: Cost effectiveness of laparoscopic cholecystectomy. J Laparoendose Surg 2:145–150, 1992Google Scholar
  4. 4.
    Hoffman GC, Baker JW, Fitchett CW, Vansant JH: Laparoscopic-assisted colectomy: Initial experience. Ann Surg 219:732–743, 1994Google Scholar
  5. 5.
    Van Ye TM, Cattey RP, Henry LG: Laparoscopically assisted colon resections compare favorably with open technique. Surg Laparose Endose 4:25–31, 1994Google Scholar
  6. 6.
    Slim K, Pezet D, Stenel J Jr, Lagha K, Roux SL, Lechner C, Chipponi J: Prospective analysis of 40 initial laparoscopic colorectal resections: A plea for a randomized trial. J Laparoendose Surg 4:241–245, 1994Google Scholar
  7. 7.
    Wexner SD, Cohen SM, Johnsen OB, Nogueras JJ, Jagelman DG: Laparoscopic colorectal surgery: A prospective assessment and current perspective. Br J Surg 80:1602–1605, 1993Google Scholar
  8. 8.
    Binderow SR, Cohen SM, Wexner SD, Nogueras JJ: Must early postoperative oral intake be limited to laparoscopy? Dis Colon Rectum 37:584–589, 1994Google Scholar
  9. 9.
    Schippers E, Öttinger AP, Anurov M, Polivoda M, Schumpelick V: Laparoscopic surgery: a minor abdominal trauma? World J Surg 17:539–543, 1993Google Scholar
  10. 10.
    Ludwig KA, Frantzides CT, Carlson MA, Grade KL: Myoelectrial motility patterns following open versus laparoscopic cholecystectomy. J Laparoendose Surg 3:461–466, 1993Google Scholar
  11. 11.
    Böhm B, Milsom JW, Fazio VW: Postoperative intestinal motility following conventional and laparoscopic intestinal surgery. Arch Surg 130:415–419, 1995Google Scholar
  12. 12.
    Elftmann TD, Nelson H, Ota DM, Pemberton JH, Beart RW, Jr: Laparoscopic-assisted segmental colectomy: Surgical techniques. Mayo Clin Proc 69:825–833, 1994Google Scholar
  13. 13.
    Kim CH, Zinmeister AR, Malagelada J-R: Mechanism of canine gastric dysrhythmia. Gastroenterology 92:993–999, 1987Google Scholar
  14. 14.
    Sarna SK: Physiology and pathophysiology of colonic motor activity: Part one of two. Dig Dis Sci 36:827–862, 1991Google Scholar
  15. 15.
    Richards RD, Valenzuela GA, Davenport KG, Fisher KLK, McCallum RW: Objective and subjective results of a randomized, double-blind, placebo-controlled trial using cisapride to treat gastroparesis. Dig Dis Sci 38:811–816, 1993Google Scholar
  16. 16.
    Schmieg RE, Schirmer BD, Combs MJ, Edwards M, Fariss A: Recovery of gastrointestinal motility after laparoscopic cholecystectomy. Surg Forum 44:135–136, 1993Google Scholar
  17. 17.
    Nachlas MM, Younis MT, Roda CP, Wityk JJ: Gastrointestinal motility studies as a guide to postoperative management. Ann Surg 175:510–522, 1972Google Scholar
  18. 18.
    Daniel EE, Tougas G, Allescher H-D, Vergara P, Fox-Threlkeld J-A: Mediators and enteric nerve pathways controlling gastric emptying. Dig Dis Sci 39:63S-68S, 1994Google Scholar
  19. 19.
    Nelsen TS, Kohatsu S: Clinical electrogastrography and its relationship to gastric surgery. Am J Surg 116:215–222, 1968Google Scholar
  20. 20.
    Hocking MP, Harrison WD, Sninsky CA: Gastric dysrhythmias following pylorus-preserving pancreaticoduodenectomy: Possible mechanism for early delayed gastric emptying. Dig Dis Sci 35:1226–1230, 1990Google Scholar
  21. 21.
    Dubois A: Gastric dysrhythmias: pathophysiologic and etiologic factors. Mayo Clin Proc 64:246–250, 1989Google Scholar
  22. 22.
    Bueno L, Ferre JP, Ruckebusch Y: Effect of anesthesia and surgical procedures on intestinal myoelectric activity in rats. Am J Dig Dis 23:690–695, 1978Google Scholar
  23. 23.
    Waldhausen JH, Shaffrey ME, Skenderis BS Jr, Jones RS, Schirmer BD: Gastrointestinal myoelectric and clinical patterns of recovery after laparotomy. Ann Surg 211:777–785, 1990Google Scholar
  24. 24.
    Schippers E, Hölscher AH, Bollschweiler E, Siewert JR: Return of interdigestive motor complex after abdominal surgery: End of postoperative ileus? Dig Dis Sci 36:621–626, 1991Google Scholar
  25. 25.
    Phillips SF: Large intestine:In Atlas of Gastrointestinal Motility in Health and Disease. MM Schuster (eds). Baltimore, Williams & Wilkins, 1993, pp 215–228Google Scholar
  26. 26.
    Hotokezaka M, Dix J, Mentis EP, Minasi JS, Schirmer BD: Gastrointestinal recovery following laparoscopic versus open colon surgery. Surg Endosc 9:215, 1995 (abstract)Google Scholar
  27. 27.
    Jacquet P, Averbach AM, Stephens AD, Sugarbaker PH: Cancer recurrence following laparoscopic colectomy: Report of two patients treated with heated intraperitoneal chemotherapy. Dis Colon Rectum 38:1110–1114, 1995Google Scholar
  28. 28.
    Jones DB, Guo L-W, Reinhard MK, Soper NJ, Philpott GW, Connett J, Fleshman JW: Impact of pneumoperitoneum on trocar site implantation of colon cancer in hamster model. Dis Colon Rectum 38:1182–1188, 1995Google Scholar

Copyright information

© Plenum Publishing Corporation 1996

Authors and Affiliations

  • Masayuki Hotokezaka
    • 2
    • 1
  • Matthew J. Combs
    • 2
    • 1
  • Bruce D. Schirmer
    • 2
    • 1
  1. 1.University of Virginia Health Sciences CenterCharlottesville
  2. 2.Department of SurgeryUniversity of Virginia Health Sciences CenterCharlottesville

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