Abstracts
1998 Digestive Disease Week
#992
COMPARISON OF MEASUREMENT METHODS CALCULATING RECOVERY OF GASTROINTESTINAL MOTILITY FOLLOWING SURGERY. M. Ishikawa, M. Hotokezaka, M.C. Blair, B.D. Schirmer. Department of Surgery, University of Virginia Health Sciences Center, Charlottesville, VA.
The aim of this study was to compare the sensitivity of several types of methods to calculate recovery of gastrointestinal motility following surgery. Myoelectric activity recordings, transit time studies and gastric emptying studies were performed in the following surgery models in dogs: open cholecystectomy (OC), laparoscopic cholecystectomy (LC), laparoscopic cholecystectomy plus peritoneal injury (LC+P), laparoscopic cholecystectomy plus installation of bile into the abdominal cavity (LC+B), laparoscopic cholecystectomy plus installation of sterile dog feces solution into the abdominal cavity (LC+F), laparoscopic cholecystectomy plus installation of E.Coli into the upper abdominal cavity with dog feces solution (LC+EU), and laparoscopic cholecystectomy plus installation of E.Coli into the pelvic space with dog feces solution (LC+EP).
Parameters of myoelectric activity recordings (slow wave frequencies, return of myoelectric motor complexes (MMCs), MMC cycle length and conduction velocity, and colonic discrete and continuous electric response activities) showed no differences between any two of the models. Transit time studies showed significant delay in the average time to passage of markers ingested at surgery compared to preoperative studies (p<0.01) in all models. The data of gastric emptying studies (% retained food at 120 min) were:
Group
|
Base
|
POD 1
|
POD 2
|
OC (n = 6)
|
39.2 ± 5.1
|
68.7 ± 5.4**
|
49.2 ± 6.0
|
LC (n = 6)
|
35.7 ± 4.8
|
48.0 ± 3.1*
|
38.0 ± 3.3
|
LC + P (n = 6)
|
27.4 ± 6.1
|
63.0 ± 7.8#
|
35.3 ± 2.1
|
LC + B (n = 6)
|
27.3 ± 4.8
|
48.2 ± 6.5*
|
35.8 ± 4.7
|
LC + F (n = 6)
|
27.7 ± 7.5
|
50.2 ± 10.8
|
33.7 ± 5.2
|
LC + EU (n = 6)
|
24.2 ± 4.5
|
68.2 ± 7.5##
|
50.9 ± 9.1**
|
LC + EP (n = 4)
|
24.2 ± 4.3
|
67.2 ± 4.8##
|
39.3 ± 5.9*
|
(*: p < 0.05, **: p < 0.03, #: p < 0.01, ##: p < 0.001 vs Base)
Myoelectric activity recordings were too insensitive and transit time studies were too sensitive to calculate postoperative recovery of gastrointestinal motility. Gastric emptying studies seem most accurate in calculating the recovery of gastrointestinal motility after surgery.
Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.
|
500 Cummings Center
+1 978-927-8330
+1 978-524-0498
