Abstract
PURPOSE: Colonic motility is crucial for the resolution of postoperative ileus. However, few data are available on postoperative colonic motility and no data on postoperative colonic tone. We aimed to characterize postoperative colonic tone and motility in patients. METHODS: Nineteen patients were investigated with combined barostat and manometry recordings after left colonic surgery. During surgery a combined recording catheter was placed in the colon with two barostat bags and four manometry channels cephalad to the anastomosis. Recordings were performed twice daily from Day 1 to Day 3 after surgery. RESULTS: Manometry showed an increasing colonic motility index, which was a mean (± standard error of the mean) of 37±5 mmHg/minute on Day 1, 87±19 mmHg/minute on Day 2, and 102±13 mmHg/minute on Day 3 (P<0.05 for Day 1vs. Day 2 and Day 2vs. Day 3). Low barostat bag volumes indicating a high colonic tone were observed on Day 1 after surgery and increased subsequently (barostat bag I was 19±4, 32±6, and 32±6 ml; barostat bag II was 13±1, 19±3, and 22±5 ml on Days 1, 2, and 3, respectively; for both barostat bagsP<0.05 for Day 1vs. Day 2 but not Day 2vs. Day 3). CONCLUSIONS: Colonic motility increased during the postoperative course. The low barostat bag volumes indicated a high colonic tone postoperatively which would correspond to a contracted rather than to a distended colon. High colonic tone postoperatively may be relevant for pharmacologic treatment of postoperative ileus.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Livingston EH, Passaro EP. Postoperative ileus. Dig Dis Sci 1990;35:121–32.
Wilson JP. Postoperative motility of the large intestine in man. Gut 1975;16:689–92.
Bufo AJ, Feldman S, Daniels GA, Lieberman RC. Early postoperative feeding. Dis Colon Rectum 1994;37:1260–5.
Waldhausen JH, Shaffrey ME, Skenderis BS, Jones RS, Schirmer BD. Gastrointestinal myoelectric and clinical patterns of recovery after laparotomy. Ann Surg 1990;211:777–84.
Woods JH, Lief W, Erickson MD, Condon RE, Schulte WJ, Sillin LF. Postoperative ileus: a colonic problem? Surgery 1978;84:527–33.
Graber JN, Schulte WJ, Condon RE, Cowles VE. Relationship of duration of postoperative ileus to extent and site of operative dissection. Surgery 1982;92:87–92.
Condon RE, Frantzides CT, Cowles VE, Mahoney JL, Schulte WJ, Sarna SK. Resolution of postoperative ileus in humans. Ann Surg 1986;203:574–81.
Roberts JP, Benson MJ, Rogers MS, Deeks JJ, Williams NS. Characterization of distal colonic motility in early postoperative period and effect of colonic anastomosis. Dig Dis Sci 1994;39:1961–7.
Janssen PA. Pirinitramide (R3365), a potent analgesic with unusual chemical structure. J Pharm Pharmacol 1961;13:513–30.
Steadman CJ, Phillips SF, Camilleri M, Haddad AC, Hanson RB. Variation of muscle tone in the human colon. Gastroenterology 1991;101:373–81.
Karaus M, Wienbeck J, Lübke HJ, Wienbeck M, Erckenbrecht JF. Computerized differentiation of short and long duration contractions in the colon: regional differences and the gastrocolonic reflex [abstract]. Gastroenterology 1988;95:A873.
Whitehead WE, Delvaux M, The Working Team. Standardization of barostat procedures for testing smooth muscle tone and sensory thresholds in the gastrointestinal tract. Dig Dis Sci 1997;42:223–41.
Steadman CJ, Phillips SF, Camilleri M, Talley NJ, Haddad A, Hanson R. Control of muscle tone in the human colon. Gut 1992;33:541–6.
Frantzides CT, Cowles V, Salaymeh B, Tekin E, Condon RE. Morphine effects on human colonic myoelectric activity in the postoperative period. Am J Surg 1992;163:144–8.
Painter NS, Truelove SC. The intraluminal pressure patterns in diverticulosis of the colon (Parts I and II). Gut 1964;5:201–13.
Painter NS, Truelove SC. The intraluminal pressure patterns in diverticulosis of the colon (Parts III and IV). Gut 1964;5:201–13.
Gillis RA, Dias Souza J, Hicks KA,et al. Inhibitory control of proximal colonic motility by the sympathetic nervous system. Am J Physiol 1987;253:G531–9.
Wilson JP. Postoperative motility of the large intestine in man. Gut 1975;16:689–92.
Dorudi S, Berry AR, Kettlerwell MG. Acute colonic pseudo-obstruction. Br J Surg 1992;79:99–103.
Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie's syndrome): an analysis of 400 cases. Dis Colon Rectum 1986;29:203–10.
Zittel TT, Lloyd KC, Rothenhöfer I, Wong H, Walsh JH, Raybould HE. Calcitonin gene-related peptide and spinal afferents partly mediate postoperative colonic ileus in the rat. Surgery 1998;123:518–27.
Holzer P, Lippe IT, Holzer-Petsche U. Inhibition of gastrointestinal transit due to surgical trauma or peritoneal irritation is reduced in capsaicin-treated rats. Gastroenterology 1986;91:360–3.
Dubois A, Weise VK, Kopin IJ. Postoperative ileus in the rat: physiopathology, etiology and treatment. Ann Surg 1973;178:781–6.
Salaymeh BM, Cowles VE, Tekin E, Zhu YR, Browne BJ, Condon RE. Selective adrenergic agonists and colon motility in monkeys. Surgery 1992;111:694–8.
Zittel TT, Huge A, Kreis ME,et al. Substance P and nitric oxide partly mediate postoperative gastric ileus in rats [abstract]. Gastroenterology 1998;114:S0278.
Espat NJ, Cheng G, Kelley MC, Vogel SB, Sninsky CA, Hocking MP. Vasoactive intestinal peptide and substance P receptor antagonists improve postoperative ileus. J Surg Res 1995;58:719–23.
De Winter BY, Boeckxstaens GE, De Man JG, Moreels TG, Herman AG, Pelckmans PA. Effect of adrenergic and nitrergic blockade on experimental ileus in rats. Br J Pharmacol 1997;120:464–8.
Roberts JP, Benson MJ, Rogers J, Deeks JJ, Wingate DL, Williams NS. Effect of cisapride on distal colonic motility in the early postoperative period following left colonic anastomosis. Dis Colon Rectum 1995;38:139–45.
Author information
Authors and Affiliations
Additional information
Supported by grants to Dr. Kreis from the University of Tübingen (fortüne 23) and the Deutsche Forschungsgemeinschaft (Kr 1816/1-1). Dr. Huge is supported by the Deutsche Forschungsgemeinschaft (Zi 415/4-1).
Published in part in abstract form inGastroenterology 1998;114:G3167.
About this article
Cite this article
Huge, A., Kreis, M.E., Zittel, T.T. et al. Postoperative colonic motility and tone in patients after colorectal surgery. Dis Colon Rectum 43, 932–939 (2000). https://doi.org/10.1007/BF02237353
Issue Date:
DOI: https://doi.org/10.1007/BF02237353