| Project/Area Number |
08671403
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Hirosaki University |
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Principal Investigator |
MORITA Takayuki Department of Surgery, Hirosaki University Hospital Instructor, 医学部・附属病院, 講師 (30167689)
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| Co-Investigator(Kenkyū-buntansha) |
WAJIMA Naoki Department of Surgery, Hirosaki University Hospital Medical staff, 医学部・附属病院, 医員
NAKAMURA Fumihiko Department of Surgery, Hirosaki University Hospital Assistant Professor, 医学部・附属病院, 助手 (70271822)
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| Project Period (FY) |
1996 – 1998
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| Project Status |
Completed (Fiscal Year 1998)
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| Budget Amount *help |
¥2,300,000 (Direct Cost: ¥2,300,000)
Fiscal Year 1998: ¥200,000 (Direct Cost: ¥200,000)
Fiscal Year 1997: ¥800,000 (Direct Cost: ¥800,000)
Fiscal Year 1996: ¥1,300,000 (Direct Cost: ¥1,300,000)
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| Keywords | Colonic motility after rectal cancer surgery / Colonic transit study / Colonic J-pouch anastomosis / 直腸癌手術 / 術後排便障害 / 外来神経損傷 / transit study / 筋間神経叢 |
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| Research Abstract |
Abnormal motility of the large intestine often occurs after resection of the sympathetic and parasympathetic nerves that innervate the colon. The intestinal motility of patients who had received sphincter-preserving operation for rectal cancer and normal subjects, were measured by determining the large bowel transit time using a radiopaque marker. The large bowel transit time was measured in the 133 patients before and after low anterior resection for rectal cancer. The average large bowel transit time in the patients before the surgery was 29.8 hours (n=30), which was similar to that in the normal subjects(29.7 hours, n=26). After the surgery, however, the average large bowel transit time of the 95 patients had prolonged to 41.4hours. The speed at which the radiopaque marker moved from the cecum to the anus in normal subjects could be classified as either rapid or slow. Before surgery, 56% of the patients with rectal cancer had slow transit, while the remaining 44% had rapid transit.
… More
However, after surgery, 80% of the rapid transit patients converted to slow transit, resulting in an increasing in the percentage of slow transit patients to over 90% after surgery. Further studies showed that slow passage of the radiopaque marker in the slow transit patients could be attributed to slow colonic motility at the distal side of Cannon's point. The large bowel transit time in patients in whom the inferior mesenteric artery and/or the left colonic artery was maintained intact during the surgery, did not differ. These results suggested that damages to the parasympathetic nerves which innervate the distal side of Cannon's point causes the postoperative changes in intestinal motility of the colon.
We also performed an anorectal manometric study who had sphincter preserving operation with colonic J-pouch anastomosis or straight anastomosis. The study after I. M. injection of neostigmin showed that the patients who had received J-pouch anastomosis had no abnormal movement of the colon on the oral side of the anastomosis.
In the patients who received straight anastomosis, the intestinal movement on the oral side of the anastomosis was spastic and unstable.
In Summary, intestinal motility is reduced following rectal cancer surgery. The patients who received colonic J-pouch anastomosis procedure have significantly fewer problems in daily life. Less
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