High-resolution colonic motility recordings in vivo compared with ex vivo recordings after colectomy, in patients with slow transit constipation
High-resolution colonic motility recordings in vivo compared with ex vivo recordings after colectomy, in patients with slow transit constipation
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DOI：
10.1111/nmo.12884
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发表时间：
2016-12-01
影响因子：
3.5
通讯作者：
Spencer, N. J.
中科院分区：
文献类型：
--
作者：
Dinning, P. G.;Sia, T. C.;Spencer, N. J.
背景慢传输型便秘（STC）的发病机制目前尚不清楚，其内在和外在的异常都有牵连。在这里，我们展示了四名STC患者在全结肠切除术前以及随后在切除后离体记录的高分辨率结肠测压记录。方法在四名女性、治疗抵抗性STC患者（中位年龄35.5岁）中，在结肠镜的帮助下，将光纤测压导管（72个传感器，间隔1厘米）放置在横结肠中段。在餐前和餐后2小时记录结肠测压。结肠切除术后，在器官浴中记录离体结肠测压。离体记录也从结肠从4例（2名男性;平均年龄67.5岁）进行前切除术的非梗阻性癌（对照组织）。关键结果A大的增加，在短期的单传播收缩记录在STC结肠离体相比，在体内（离体61.3 - 32.7与体内2.5 +/- 5/h）。在STC患者中，在体内，收缩活动的优势频率为2-3个周期/分钟（cpm），而离体1-cpm的短单传播收缩占主导地位。同样的1-cpm频率也占主导地位，在控制结肠离体。结论与InferencesIn相比，控制成人，STC患者的结肠表现出显着减少传播运动活动。然而，一旦STC结肠从身体中切除，它就表现出对控制组织的常规和相似的传播活动频率。本文提供了有趣的见解结肠运动模式的控制。
BackgroundThe pathogenesis of slow transit constipation (STC) remains poorly understood, with intrinsic and extrinsic abnormalities implicated. Here, we present high-resolution colonic manometry recordings from four STC patients recorded before total colectomy, and subsequently, ex vivo, after excision.MethodsIn four female, treatment-resistant STC patients (median age 35.5 years), a fiber-optic manometry catheter (72 sensors spaced at 1 cm intervals) was placed with the aid of a colonoscope, to the mid-transverse colon. Colonic manometry was recorded 2 h before and after a meal. After the colectomy, ex vivo colonic manometry was recorded in an organ bath. Ex vivo recordings were also made from colons from 4 patients (2 male; median age 67.5 years) undergoing anterior resection for nonobstructive carcinoma (control' tissue).Key ResultsA large increase in short single propagating contractions' was recorded in STC colon ex vivo compared to in vivo (ex vivo 61.3 32.7 vs in vivo 2.5 +/- 5/h). In STC patients, in vivo, the dominant frequency of contractile activity was 2-3 cycle per minute (cpm), whereas 1-cpm short-single propagating contractions dominated ex vivo. This same 1-cpm frequency was also dominant in control colons ex vivo.Conclusions & InferencesIn comparison to control adults, the colon of STC patients demonstrates significantly less propagating motor activity. However, once the STC colon is excised from the body it demonstrates a regular and similar frequency of propagating activity to control tissue. This paper provides interesting insights into the control of colonic motor patterns.