Priliminary study to develop a perineal artificial anus

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[AIM] To assess the diurnal motor profile in colostomized segment[METHODS] Four force transducers (FT_<1-4>) were implanted on the colon of 9 dogs at an equidistance and another FT on the terminal ileum to distinguish the digestive from interdigestive phase. The dogs were fed either 20 or 10 g/kg meal to modify the duration of the digestive phase and a 24 recording was performed. The duration of a contraction burst (contractile state, CS) and the length of each motor quiescent state (QS) were plotted against postprandial time. Later the colon was transected between FT_2 and FT_3 to establish a double-barrelled colostomy and a 24 h recording was resumed.[RESULTS] In the intact dogs with either 20 or 10 g/kg meal, CS at each FT did not change significantly, while QS shortened at 2-4 h and began to significantly increase at 15.3(]SY.+-。[)0.3 h with 20 g/kg meal and at 11.5(]SY.+-。[)0.8 h with 10 g meal. The onset of this QS prolongation was closely correlated with the appearance of the first ileal MMC (r=0.95-0.92, p<0.001). In the colostomized dogs, the motor profile in the oral colon was identical to that before colostomy, while no prolongation of QS in the interdigestive phase occurred in the distal colon. Instead, CS and QS recurred periodically with a fixed cycle of 4.7(]SY.+-。[)0.1 min for CS and 32.6(]SY.+-。[)1.8 min for QS,respectively.[CONCLUSION] Prolongation of QS is temporally locked with the beginning of the interdigestive phase. Bowel continuity is essential for this QS prolongation to occur throughout the colon. Each segment of the colon may have its own contractile rhythm which is entrained by the rhythm in a more proximal adjacent segment (relaxation oscillator).