Colorectal motility induction by sacral nerve Electrostimulation in a canine model - Implications for colonic pacing
Colorectal motility induction by sacral nerve Electrostimulation in a canine model - Implications for colonic pacing
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DOI：
10.1007/s10350-004-6661-7
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发表时间：
2003-06-01
影响因子：
3.9
通讯作者：
Kitajima, M
中科院分区：
文献类型：
--
作者：
Hirabayashi, T;Matsufuji, H;Kitajima, M
目的：研究骶神经在成年杂种狗排便机制中的作用。本文还讨论了设计结肠起搏器作为治疗大便失禁和严重便秘等排便障碍的新治疗装置的可能性。方法：通过在近端、远端和乙状结肠、直肠和内肛门括约肌植入力应变传感器来监测自然排便时结肠直肠的运动。全麻下电刺激骶神经，观察结直肠运动反应。结果：在自然排便过程中，观察到三种特征性的运动模式：1)结肠的巨大迁移收缩传播到直肠或肛门；2)大迁移性收缩传播前直肠松弛；3)内括约肌在大迁移收缩传播过程中松弛。骶神经刺激引起以下三种独特的反应：1)收缩运动从结肠远端传播到直肠；2)直肠有松弛反应；3)内肛门括约肌出现松弛反应。骶神经电刺激引起的收缩反应的持续时间和传播速度与自然排便时的收缩反应的持续时间相似，但其幅度较小。结论：骶神经影响排便过程中结肠和肛肠的协调过程。这表明设计结肠起搏器来控制结肠和直肠下部运动是可能的。
PURPOSE: This study investigated the role of the sacral nerves in the mechanism of defecation using adult mongrel dogs. The possibility of designing a colonic pacemaker as a new therapeutic device to treat defecation disturbances, such as fecal incontinence and severe constipation, is also discussed. METHODS: Colorectal motility during spontaneous defecation was monitored with force strain-gauge transducers implanted in the proximal, distal, and sigmoid colon, rectum, and internal anal sphincter. Under general anesthesia, the sacral nerve was stimulated electrically, and the colorectal motility response was examined. RESULTS: During spontaneous defecation, three characteristic motility patterns were observed: 1) giant migrating contractions of the colon were propagated to the rectum or anus; 2) the rectum relaxed before the giant migrating contractions were propagated; and 3) the internal anal sphincter was relaxed during the propagation of the giant migrating contraction. Sacral nerve stimulation elicited the following three unique responses: 1) contractile movements were propagated from the distal colon to the rectum; 2) a relaxation response was noted in the rectum; and 3) the internal anal sphincter exhibited a relaxation response. The duration and propagation velocity of the contractile responses and the duration of relaxation responses elicited by electrical stimulation of the sacral nerve were similar to those that occurred during spontaneous defecation, but their amplitudes were smaller. CONCLUSION: The coordinated processes of the colon and anorectum during defecation were affected by the sacral nerves. This suggests that it is possible to design a colonic pacemaker to control lower colonic and rectal movements.