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Adaptation to surgical perturbations

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Abstract

The sections in this article are:

1 Postoperative Paresis (Ileus)
2 Esophagus
3 Stomach
3.1 Resection
3.2 Vagotomy
4 Small Intestine
4.1 Transection
4.2 Resection
4.3 Vagotomy
5 Large Intestine
6 Conclusions
Figure 1. Figure 1.

Electrical activity of muscle wall of small (I) and large (C) intestine in patient in early postoperative period. A: day 1; B: day 2; C: day 5 after surgery.

From Zlatarski et al.
Figure 2. Figure 2.

Changes in pressure and electrical potentials of gastroesophageal sphincter (GES) during balloon distension of esophagus.

From Arimori et al.
Figure 3. Figure 3.

Simultaneous detection of electrical activity (EA) and intraluminal pressure (P) of vagally innervated and vagally denervated portions of dog esophagus during swallowing. In vagotomized segment, pressure increase was feeble and electrical activity much lower than in vagally intact segment. Exact temporal association between electrical activity and pressure changes was also abolished.

From Arimori et al.
Figure 4. Figure 4.

Slow potential changes from fundic muscle wall before and after Billroth I gastrectomy. A: sinusoidal slow waves from smooth muscle cell of intact fundus in cat. B: spontaneous electrical activity of single smooth muscle cell from gastric remnant after functional loading: configuration of action potential‐type plateau. MP, electrical activity; T, contractile activity of smooth muscle strip.

From Bayguinov and Atanassova
Figure 5. Figure 5.

Dynamics of changes in nerve transmission of gastric remnant after subtotal gastrectomy. D + C, depolarization and contraction of smooth muscle strip; D + R, depolarization and relaxation; H + R, hyperpolarization and relaxation; H + C, hyperpolarization and contraction; B, biphasic responses.

From Atanassova et al.
Figure 6. Figure 6.

Percentage correlation of slow waves with spike potentials to total number of slow waves in stomach (A) and duodenum (B) with intact (open bars) and transected (hatched bars) gastroduodenal junction.

From Atanassova
Figure 7. Figure 7.

Reconstructive gastric operations employed. A: Roux gastrojejunostomy; B: jejunal interposition; C: pyloric reconstruction.

From Kelly et al. , by permission of the publishers, Butterworth and Co., copyright 1981
Figure 8. Figure 8.

Disturbance of unified character of pacesetter potential rhythm of the antrum. A: before; B: after thoracic vagotomy. Upper left corner, position of electrodes; calibration 200 μV.

From Papasova and Atanassova
Figure 9. Figure 9.

Lack of coordination between electrical and contractile activities of corpus (C) and antrum (A) of dog stomach after bilateral transthoracic vagotomy. Tc and Ta, contractile activity in corpus and antrum, respectively.

From Papasova and Atanassova
Figure 10. Figure 10.

Dynamics of changes in phases of migrating myoelectrical complexes in stomach at different periods after vagotomy.

From Atanassova
Figure 11. Figure 11.

Intragastric basal pressure of different volumes before (solid line) and after (dotted line) proximal gastric vagotomy (PGV). Balloon volumes are given along the x‐axis. Curves represent mean values with vertical bars indicating ± SEM; P values given for significant differences between values before and after PGV.

From Stadaas
Figure 12. Figure 12.

Dissociation of spike activity of 2 duodenal segments after transection. A: spreading of groups of spike potentials from stomach in proximal duodenum to transection site; B: spike activity of distal duodenal segment in quiescent state of stomach and of proximal duodenum. Trace 1, stomach; traces 2 and 3, above transection; traces 4 and 5, below transection. Time in seconds.

From Atanassova et al.
Figure 13. Figure 13.

Model of migrating myoelectrical complexes (MMC). Each segment of small intestine behaves like an independent MMC relaxation oscillator. Oscillators are coupled by intrinsic cholinergic neurons.

From Sarna et al.
Figure 14. Figure 14.

Dynamics of changes in phases of migrating myoelectrical complexes of small intestine at different periods after vagotomy,

from Atanassova
Figure 15. Figure 15.

Electrical activity of dog colonic muscle wall in experimental obstruction. A: 24 h after making of a ligature between electrodes (small numbers) 6 and 7; B: 48 h later; C: 72 h later; D: 24 h after removing ligature.

Data from E. Atanassova, G. Zlatarski, and C. Christov, unpublished observations
Figure 16. Figure 16.

Antiperistaltic spreading of spike activity from transverse colon to ileum during experimental obstruction. Trace 2, ileum; trace 3, proximal colon; trace 4, transverse colon.

Data from E. Atanassova, G. Zlatarski, and C. Christov, unpublished observations


Figure 1.

Electrical activity of muscle wall of small (I) and large (C) intestine in patient in early postoperative period. A: day 1; B: day 2; C: day 5 after surgery.

From Zlatarski et al.


Figure 2.

Changes in pressure and electrical potentials of gastroesophageal sphincter (GES) during balloon distension of esophagus.

From Arimori et al.


Figure 3.

Simultaneous detection of electrical activity (EA) and intraluminal pressure (P) of vagally innervated and vagally denervated portions of dog esophagus during swallowing. In vagotomized segment, pressure increase was feeble and electrical activity much lower than in vagally intact segment. Exact temporal association between electrical activity and pressure changes was also abolished.

From Arimori et al.


Figure 4.

Slow potential changes from fundic muscle wall before and after Billroth I gastrectomy. A: sinusoidal slow waves from smooth muscle cell of intact fundus in cat. B: spontaneous electrical activity of single smooth muscle cell from gastric remnant after functional loading: configuration of action potential‐type plateau. MP, electrical activity; T, contractile activity of smooth muscle strip.

From Bayguinov and Atanassova


Figure 5.

Dynamics of changes in nerve transmission of gastric remnant after subtotal gastrectomy. D + C, depolarization and contraction of smooth muscle strip; D + R, depolarization and relaxation; H + R, hyperpolarization and relaxation; H + C, hyperpolarization and contraction; B, biphasic responses.

From Atanassova et al.


Figure 6.

Percentage correlation of slow waves with spike potentials to total number of slow waves in stomach (A) and duodenum (B) with intact (open bars) and transected (hatched bars) gastroduodenal junction.

From Atanassova


Figure 7.

Reconstructive gastric operations employed. A: Roux gastrojejunostomy; B: jejunal interposition; C: pyloric reconstruction.

From Kelly et al. , by permission of the publishers, Butterworth and Co., copyright 1981


Figure 8.

Disturbance of unified character of pacesetter potential rhythm of the antrum. A: before; B: after thoracic vagotomy. Upper left corner, position of electrodes; calibration 200 μV.

From Papasova and Atanassova


Figure 9.

Lack of coordination between electrical and contractile activities of corpus (C) and antrum (A) of dog stomach after bilateral transthoracic vagotomy. Tc and Ta, contractile activity in corpus and antrum, respectively.

From Papasova and Atanassova


Figure 10.

Dynamics of changes in phases of migrating myoelectrical complexes in stomach at different periods after vagotomy.

From Atanassova


Figure 11.

Intragastric basal pressure of different volumes before (solid line) and after (dotted line) proximal gastric vagotomy (PGV). Balloon volumes are given along the x‐axis. Curves represent mean values with vertical bars indicating ± SEM; P values given for significant differences between values before and after PGV.

From Stadaas


Figure 12.

Dissociation of spike activity of 2 duodenal segments after transection. A: spreading of groups of spike potentials from stomach in proximal duodenum to transection site; B: spike activity of distal duodenal segment in quiescent state of stomach and of proximal duodenum. Trace 1, stomach; traces 2 and 3, above transection; traces 4 and 5, below transection. Time in seconds.

From Atanassova et al.


Figure 13.

Model of migrating myoelectrical complexes (MMC). Each segment of small intestine behaves like an independent MMC relaxation oscillator. Oscillators are coupled by intrinsic cholinergic neurons.

From Sarna et al.


Figure 14.

Dynamics of changes in phases of migrating myoelectrical complexes of small intestine at different periods after vagotomy,

from Atanassova


Figure 15.

Electrical activity of dog colonic muscle wall in experimental obstruction. A: 24 h after making of a ligature between electrodes (small numbers) 6 and 7; B: 48 h later; C: 72 h later; D: 24 h after removing ligature.

Data from E. Atanassova, G. Zlatarski, and C. Christov, unpublished observations


Figure 16.

Antiperistaltic spreading of spike activity from transverse colon to ileum during experimental obstruction. Trace 2, ileum; trace 3, proximal colon; trace 4, transverse colon.

Data from E. Atanassova, G. Zlatarski, and C. Christov, unpublished observations
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Maria Papasova, Elena Atanassova. Adaptation to surgical perturbations. Compr Physiol 2011, Supplement 16: Handbook of Physiology, The Gastrointestinal System, Motility and Circulation: 1199-1224. First published in print 1989. doi: 10.1002/cphy.cp060133