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- Title
Role of the vagus nerve on the development of postoperative ileus.
- Authors
Zhirong Gao; Müller, Mario H.; Karpitschka, Martina; Mittler, Sarah; Kasparek, Michael S.; Renz, Bernhard; Sibaev, Andrej; Glatzle, Jörg; Yongyu Li; Kreis, Martin E.
- Abstract
Postoperative ileus involves reflex inhibition of intestinal motility within hours after surgery and a subsequent intestinal inflammatory response that is characterized by efferent vagal modulation via acetylcholine receptors on intestinal macrophages. We aimed to characterize the role of vagal modulation of intestinal motility during the early hours after surgery. C57BL6 mice underwent laparotomy and standardized small bowel manipulation to induce postoperative ileus. Subgroups were vagotomized 3–4 days prior to experiments or received pharmacological inhibition of the acetylcholine α7 subunit with the inhibitor α-bungarotoxin, while control animals were sham operated and remained otherwise untreated. Three hours later, a 2-cm jejunal segment was harvested with the mesentery attached. Mesenteric afferent nerve recordings were established in an organ bath generating a multiunit signal with subsequent computerized analysis. Intraluminal pressure was continuously recorded to assess intestinal motility. Afferent nerve responses were quantified at baseline and to chemical stimulation with bradykinin (0.5 µM) or serotonin (5-HT; 500 µM) and following mechanical stimulation by continuous ramp distension to 60 mmHg. Peak amplitudes of intestinal motility and afferent nerve discharge at baseline were not different following chronic vagotomy, α-bungarotoxin or sham operation. Maximum afferent discharge to 5-HT following α-bungarotoxin was comparable to sham controls, while the response was reduced in chronically vagotomized animals ( p < 0.05). Maximum afferent nerve discharge to bradykinin and peak firing during maximum distension at 60 mmHg was similar in the different subgroups. At luminal distension from 10 to 30 mmHg, afferent discharge was lower in vagotomized animals compared to sham controls ( p < 0.05) but unchanged after α-bungarotoxin. Sensitivity to low-threshold distension and 5-HT is mediated via vagal afferents during postoperative ileus, while sensitivity to high-threshold distension and bradykinin is independent of vagal afferent innervation. Early inhibition of intestinal motility at 3 h after onset of postoperative ileus does not appear to depend on vagal innervation.
- Subjects
VAGUS nerve; BOWEL obstructions; SURGERY; ACETYLCHOLINE; SEROTONIN
- Publication
Langenbeck's Archives of Surgery, 2010, Vol 395, Issue 4, p407
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s00423-010-0594-5