Hyperactive cyclic motor activity in the distal colon after colonic surgery as defined by high-resolution colonic manometry

Abstract

Distal gut motility becomes markedly hyperactive with colonic surgery, dominated by cyclic motor patterns. This hyperactivity likely represents a novel pathophysiological aspect of the surgical stress response. Hyperactive motility may contribute to gut dysfunction after surgery, potentially offering a new therapeutic target to enhance recovery.

Development and feasibility of an ambulatory acquisition system for fiber‐optic high‐resolution colonic manometry

“…The mean amplitude (37.0 ± 7.6 vs 32.8 ± 11.9 mm Hg, P = .65), velocity (2.1 ± 0.1 vs 1.2 ± 0.6 cm/s, P = .10), and extent of propagation (7.3 ± 1.0 vs 6.1 ± 0.8 cm, P = .12) were also similar between ambulatory and non‐ambulatory recordings. No high‐amplitude propagating sequences (HAPS) were observed during the analyzed manometry recordings, consistent with other postoperative data . There was no apparent migration of the manometry catheter during the recordings, and studies were successfully completed without damage to the catheter or acquisition unit.…”

“…B, Bland‐Altman plot comparing ambulatory and non‐ambulatory systems showing good agreement within 95% confidence limits. C & D, Hyperactive postoperative cyclic motor patterns recorded using the ambulatory and non‐ambulatory systems, respectively, showing a pronounced hyperactive motor pattern comparable to that described by Vather et al E, Overview plot of 18 h of continuous postoperative ambulatory recordings from a single patient…”

“…Ambulatory manometry data were obtained during the first eight hours postoperatively for two of the three patients, with the third having recordings over days 3‐4 postoperatively. These data were analyzed and compared to previously published data from the early postoperative period from a similar cohort (n = 8) using the non‐ambulatory manometry system . Similar to recent observations published elsewhere, the distal colonic motility in the early postoperative period was dominated by hyperactive cyclic motor patterns (Figure C‐E).…”

“…High‐resolution (HR) colonic manometry is an emerging technique, enabling recordings up to the full length of the colon with sensors spaced at 1 cm intervals, yielding improved spatiotemporal detail . This novel technology has provided new insights into colonic motility in health, and in a range of motility disorders including bowel dysfunction in the early postoperative period following abdominal surgery …”

“…Previous HR colonic manometry studies have been limited by the need for a bulky non‐portable acquisition system connected to a computer for data recording and storage (Figure ). This is particularly restrictive in the postoperative setting, where patient mobilization is required as part of surgical recovery . Participants have been unable to mobilize with the catheter in situ without manually disconnecting from the acquisition system, thus limiting the duration of continuous recordings and preventing longitudinal assessment of postoperative colonic motility.…”