Colon interposition for esophageal replacement: isoperistaltic or antiperistaltic? Experimental results Bernhard Dreuw, MD, Jürgen Fass, PhD, Svetlana.

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Presentation transcript:

Colon interposition for esophageal replacement: isoperistaltic or antiperistaltic? Experimental results Bernhard Dreuw, MD, Jürgen Fass, PhD, Svetlana Titkova, MD, Michail Anurov, MD, Michail Polivoda, MD, Alexander P Öttinger, MD, Volker Schumpelick, MD The Annals of Thoracic Surgery Volume 71, Issue 1, Pages 303-308 (January 2001) DOI: 10.1016/S0003-4975(00)02256-6

Fig 1 Experimental model: isoperistaltic or antiperistaltic colon segments as a Roux-Y loop with skin fistula. □ 1–5: Orientation of the strain gauges. A, a = proximal colon; B, b = distal colon. The antiperistaltic colon segments are arranged antiperistaltically (a = distal colon; b = proximal colon). The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)

Fig 2 Antiperistaltic colonic motility complex (CMC) in a dog with antiperistaltic colon loop. After a short quiescent state another CMC occurred, this time with mixed segmental and peristaltic direction. The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)

Fig 3 Mixed isoperistaltic and antiperistaltic colonic motility complex in a dog with isoperistaltic colon loop. The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)

Fig 4 Isoperistaltic colonic motility complex in a dog with isoperistaltic colon loop. The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)

Fig 5 Retroperistalsis: Three images from the fluoroscopy series with a time gap of 10 seconds in a dog with an antiperistaltic colon loop. An antiperistaltic wave is squeezing against the balloon that occludes the skin fistula (arrows). During the same time a phase of antiperistaltic colonic motility complex was observed (Fig 2). The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)

Fig 6 Biphasic course of scinthigraphic curves in a dog with antiperistaltic colon loop. Region 1 is set to the proximal part of the colon loop; region 2 is set to the distal part of the colon loop. Initially, after filling the loop (0 minutes), activity is high in the proximal part. Then the radioactive labeled food is transported to the distal part of the loop with increasing activity distal and decreasing activity proximal (13 minutes). Instead of emptying, the food is transported back to the proximal part of the loop as indicated by an increase of radioactive activity (25 minutes). The Annals of Thoracic Surgery 2001 71, 303-308DOI: (10.1016/S0003-4975(00)02256-6)