An experimental study on the motility of rectal branches in the pelvic plexus during bowel movement

起源于盆丛的直支神经分为沿乙状结肠上行的副交感神经和壁内上行神经。目前还没有完全揭示这些分支是如何参与肠道运动的。我们研究了盆腔丛直肠分支的运动性，这些分支参与了巨结肠病的根治性手术模型的肠道运动。【材料与方法】采用四种应变式力传感器（SGT）测量四组Beagle犬排便时的结肠运动：对照组、神经切开术组、经肛门Soave手术组和开放Soave手术组。神经切开术和OS组先切断沿骶髂丛直支乙状结肠上行的副交感神经，再切断壁内上行神经。TAS组沿直肠支乙状结肠上行的副交感神经，更多源自骨盆丛的神经完整，然后壁内上行神经被切断。【结果】对照组在腹膜反射侧SGT处5 cm处出现伴排便的松弛波后不久出现高幅度收缩，腹膜反射SGT处出现伴排便的松弛波。神经切开术和OS无高振幅收缩，无松弛波伴排便。TAS无松弛波，伴排便时出现高幅度收缩，拉通吻合口上方有非典型松弛波伴排便。【结论】排便时的松弛波可能与源自盆丛的肠系膜神经有关。TAS保留沿乙状结肠上行的副交感神经，但排便时未见高幅度收缩。这些结果并未显示TAS对排便时结肠运动有任何优势。结果表明，盆腔丛直肠分支在下结肠运动和排便中起重要作用。少

The rectal branches of the nerve arising from the pelvic plexus are divided into two : the parasympathetic nerves ascending along the sigmoid, and the intramural ascending nerve. It has not been fully revealed how these branches are involved in bowel movement. We studied the motility of rectal branches in the pelvic plexus that are involved in bowel movements using radical surgical models for Hirschsprung's disease.【Materials and Methods】The colonic motility on defecation was measured by using four strain gauge force transducers (SGT) in four groups of Beagle dogs: including a control group, a Neurotomy group, a transanal Soave procedure (TAS) group and an open Soave procedure (OS) group. In the Neurotomy and OS group, the parasympathetic nerve ascending along the sigmoid of the rectal branches of the nerve arising from the pelvic plexus was cut and then the intramural ascending nerve was cut. In the TAS group, the parasympathetic nerve ascending along the sigmoid of the rectal branche … More s of the nerve arising from the pelvic plexus was intact and then the intramural ascending nerve was cut.【Results】The control group had high amplitude contraction soon after the relaxation wave with defecation at 5 cm to the oral side SGT from reflection of peritoneum and a relaxation wave with defecation in SGT of reflection of the peritoneum. The Neurotomy and OS had no high amplitude contraction and no relaxation wave with defecation. The TAS had no relaxation wave and high amplitude contraction with defecation and an atypical relaxation wave with defecation above the pulled-through anastomosis.【Conclusions】Theses results, suggest that the relaxation wave with defecation may be related to the mesenteric nerve arising from pelvic plexus. The TAS preserved the parasympathetic nerve ascending along the sigmoid, but there was no high amplitude contraction on defecation. These results did not show any advantage of TAS regarding colonic motility on defecation. It was indicated that the rectal branches of the pelvic plexus plays an important role in lower colon motility as well as in bowel movement. Less