Inhaltszusammenfassung

Autonomic nerve damage could be a cause of internal anal sphincter (IAS) dysfunction after rectal cancer treatment. The aim of the study was to investigate the effect of intraoperative pelvic nerve stimulation on IAS electromyographic signals to determine the possible role for a functional neuromonitoring. Method: Eleven pigs underwent low anterior rectal resection. Stimulation of inferior hypogastric plexus and pelvic splanchnic nerves was carried out bilaterally. Continuous electromyography...Autonomic nerve damage could be a cause of internal anal sphincter (IAS) dysfunction after rectal cancer treatment. The aim of the study was to investigate the effect of intraoperative pelvic nerve stimulation on IAS electromyographic signals to determine the possible role for a functional neuromonitoring. Method: Eleven pigs underwent low anterior rectal resection. Stimulation of inferior hypogastric plexus and pelvic splanchnic nerves was carried out bilaterally. Continuous electromyography of IAS was performed with bipolar stainless steel needle electrodes. Additional frequency analyses of IAS signals were done by using a fast Fourier transform. Results: After adapting a neuromonitoring device (NeMo, Inomed, Teningen, Germany), neuromonitoring could be realized successfully in all animals. The frequency spectrum of IAS ranged from 5–20 Hz under stimulation and still remained after curarization. The time based electromyographic signals showed increasing amplitudes and an increase in IAS activity after stimulation (1 lV vs 4 lV, p2 vs 10.6 mV2, P < 0.001). Conclusion: The feasibility of intraoperative verification of IAS function is proven in an animal model. Establishing the procedure in human nerve-sparing pelvic surgery will demonstrate its clinical impact. (supported by the Federal Ministry of Education and Research, Grand number 01EZ0722). W. Kneist, DW Kauff, AD Rink, A. Heimann, H Lang: Department of General an Abdominal Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany K. Somerlik: inomed Medizintechnik GmbH, Emmendingen, Germany T. Dörge: Fraunhofer Institute for Biomedical Engineering, St. Ingbert, Germany K.P. Koch: Fachhochschule Trier, Department Engineering, Trier, Germany T. Göttsche: Reinhardt Microtech AG, Ulm, Germany S. Hoyler: Dr. Osypka GmbH, Rheinfelden, Germany P016: Poster Abstract of the Fourth Annual Meeting of the European Society of Coloproctology, 23.-26. September 2009, Prague, Czech Republic Effect of intraoperative pelvic autonomic nerve stimulation.... Available from: https://www.researchgate.net/publication/256546920_Effect_of_intraoperative_pelvic_autonomic_nerve_stimulation_on_internal_anal_sphincter_electromyographic_activity_--_results_of_an_acute_animal_study » weiterlesen» einklappen

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DDC Sachgruppe:
Technik