Experimental studies on intestinal absorption following Martin's operation

Abstract

Experimental studies were done on rats on compensatory absorptive capacity following Martin's operation for extensive aganglionosis. Experimental aganglionosis was produced in the descending colon of rats by serosal application of 0.1% benzalkonium chloride solution. Wide side-to-side anastomosis was performed between the aganglionic colon and the distal ileum, removing the remaining colon. As to absorptive capacity of water and electrolytes, this experimental intestine was compared, with other intestines, especially control intestine, in which similar side-to-side anastomosis was done between the normal colon and the normal ileum. "Experimental" as well as control intestine showed higher absorptive capacities of water, Na and Cl per unit length than did summed up values of the ileum and the colon per unit length. Postoperative body weight curves showed fairly good increases and appearance of feces showed a fair improvement in the experimental group. Autopsy of experimental intestine revealed marked dilatation of the anastomosed ileum and mucosal hypertrophy of the anastomosed colon. These results suggested a favorable compensatory absorptive capacity following Martin's operation.

Long-term results of total colonic agangliosis patients treated by preservation of the aganglionic right hemicolon and the ileo-cecal valve

“…However, utilization of the total aganglionic colon does not only bear a higher surgical complication risk but is also associated with a higher incidence of enterocolitis and bowel obstruction, wherefore this technique has been abandoned in several institutions [18][19][20]. Sophisticated research investigations in animal studies and human subjects have shown that the right colon has superior efficiency compared to the transverse and left colon in terms of water and electrolyte absorptive capacities, also leading to a reduced transit time [21][22][23][24][25][26][27][28][29][30]. Thus, the right colonic patch has achieved popularity in TCA surgical management [4][5][6]31].…”