Intestinal surgical resection disrupts electrical rhythmicity, neural responses, and interstitial cell networks

Background & Aims: Surgical manipulations of the gastrointestinal (GI) tract, including intestinal resection and anastomosis, lead to motility disorders including a decrease in phasic and segmental contractions. The aims of the present investigation were to determine mechanisms underlying the loss of motility in a murine model of intestinal resection and to follow-up the recovery of intestinal motility after surgical manipulation. Methods: Segments of ileum were removed from mice and the intestines were reconstructed. After surgery, the structure and activity of the ileal muscles, 0-5 cm oral and aboral to the site of resection, were examined at 5 and 24 hours with intracellular microelectrode recordings, isometric force measurements, Kit-like immunohistochemistry, and electron microscopy. Results: Five hours after surgery there was loss of electrical slow waves and phasic contractions in muscles near the site of resection. This defect decreased as a function of distance above and below the resection. Tissues in the affected region were poorly responsive to carbachol and transmural nerve stimulation. Kit-like immunohistochemistry revealed disruption in interstitial cell of Cajal (ICC) networks at the level of the myenteric and deep muscular plexuses. Lesions in ICCs decreased with distance from the site of resection. Slow waves and mechanical activity recovered at the site of anastomosis 24 hours after surgery and recovered more rapidly when tissues were incubated in the inducible nitric oxide synthase (NOS) inhibitor, L-N-6-(1-Iminoethyl) lysine hydrochloride (L-NIL). Conclusions: Loss of intestinal motility after surgery is associated with acute disruption of ICC networks, slow waves, and phasic contractions. This activity partially recovered within 24 hours after surgery.