THE INFLUENCE OF COLON ANASTOMOSIS LEVELS ON LIQUID PHASE GASTRIC EMPTYING RATE
Dr. Ömer GÜNAL1, Dr. Mustafa DENİZ2, Dr. Arif ASLANER1, Dr. Mustafa SUNGUR2
1Abant izzet Baysal Üniversitesi, Düzce Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, Konuralp, Düzce.
2Marmara Üniversitesi, Tıp Fakültesi, Fizyoloji Anabilim Dalı, Haydarpaşa, İstanbul.
Abstract
The aim of this study was to investigate the effect of colonic anastomoses at different levels on liquid phase gastric emptying rate.c
Initiation of oral feeding after colorectal surgical procedures depends on the beginning of bowel movements. We hypothesize that surgical procedures which are performed at different colonic levels, may affect gastric motility and may alter the oral feeding starting time.
Liquid phase gastric emptying rates of 49 adult male Wistar Albino rats were measured with methyl cellulose phenol red test. Two groups of 14 rats underwent ascending colon or colorectal anastomosis. We also studied a sham-op group (n=14) with laparotomy only and a control group (n=7) with no surgery. Half of each group underwent gastric emptying test on postoperative first (n=7) or tenth (n=7) days.
The gastric emptying rates on the first postoperative day were (34.9+1.5%), (50.9±5.2%), and (58.3±4.5%) in colorectal anastomosis, ascending colon anastomosis, and sham-op groups, respectively. While gastric emptying rates returned to the control group levels (71.5±5.7%) on postoperative tenth day, in ascending colon anastomosis (72.5±2.1%) group and sham-op (69±1.8) group, it was still significantly lower in colorectal anastomosis (49.9+7.8%) group compared to the control group level.
This study shows that colorectal anastomosis causes a delay in liquid phase gastric emptying rate compared to ascending colon anastomosis. Our findings also imply that the influence of colonic anastomosis on gastric emptying rate appears to be related to the site of colonic anastomosis.
Keywords: Colon, anastomosis, rectum, gastric emptying.