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Recovery of Gastrointestinal Tract Motility and Myoelectric Activity Change After Abdominal Surgery

Masayuki Hotokezaka, MD; Elias P. Mentis; Samir P. Patel; Matthew J. Combs, PhD; Charles D. Teates, MD; Bruce D. Schirmer, MD
Arch Surg. 1997;132(4):410-417. doi:10.1001/archsurg.1997.01430280084013.
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Objective:  To investigate the relationship between fedstate gastrointestinal tract (GI) function and upper GI myoelectric changes seen after abdominal surgery.

Design:  Twenty-one adult female mongrel dogs underwent either an open cholecystectomy, a laparoscopic cholecystectomy alone, or a laparoscopic cholecystectomy with peritoneal injury (n=7 for each group). Bipolar recording electrodes were placed on the antrum and 3 sites of the proximal small intestine to record fasting myoelectric data each morning postoperatively. Solid-phase, technetium Tc 99m gastric emptying studies were performed on postoperative days 1 and 2. Radiopaque markers were ingested just before operation, and the excreted markers were counted using x-ray films of the feces.

Main Outcome Measures:  Postoperative fasting GI myoelectric activity, gastric emptying, and intestinal transit time.

Results:  Migrating motor complexes (MMCs) in the small intestine were observed in 33.3% and 75.0% of the dogs on postoperative days 1 and 2, respectively. Gastric dysrhythmias were observed in 23.8% and 45.0% of the dogs on postoperative days 1 and 2, respectively. No relationship between type of surgery and the presence of MMCs or gastric dysrhythmias was noted. Gastric emptying was delayed on postoperative day 1 and was unrelated to the presence of MMCs. Transit time was not significantly delayed in dogs without MMCs on postoperative day 1 compared with that in dogs with MMCs on that day. The presence of gastric dysrhythmias did not affect transit time studies.

Conclusion:  Fasting GI myoelectric activity, including the return of MMCs and the presence of gastric dysrhythmias, does not accurately predict fed-state gastrointestinal GI function following abdominal surgery.Arch Surg. 1997;132:410-417


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