Postoperative colonic motility and tone in patients after colorectal surgery

PURPOSE: Colonic motility is crucial for the resolution of postoperative il eus. However, few data are available on postoperative colonic motility and no data on postoperative colonic tone. We aimed to characterize postoperati ve colonic tone and motility in patients.,METHODS: Nineteen patients were i nvestigated with combined barostat and manometry recordings after left colo nic surgery. During surgery a combined recording catheter was placed in the colon with two barostat bags and four manometry channels cephalad to the a nastomosis. Recordings were performed twice daily from Day 1 to Day 3 after surgery. RESULTS: Manometry showed an increasing colonic motility index, w hich was a mean (+/- standard error of the mean) of 37 +/- 5 mmHg/minute on Day 1, 87 +/- 19 mmHg/minute on Day 2, and 102 +/- 13 mmHg/minute on Day 3 (P < 0.05 for Day 1 vs. Day 2 and Day 2 vs. Day 3). Low barostat bag volum es indicating a high colonic tone were observed on Day I after surgery and increased subsequently (barostat bag I was 19 +/- 4, 32 +/- 6, and 32 +/- 6 ml; barostat bag II was 13 +/- 1, 19 +/- 3, and 22 +/- 5 ml on Dap 1, 2, a nd 3, respectively; for both barostat bags P < 0.05 for Day 1 vs. Day 2 but not Day 2 vs. Day 3). CONCLUSIONS: Colonic motility increased during the p ostoperative course. The low barostat bag volumes indicated a high colonic tone postoperatively which would correspond to a contracted rather than to a dis tended colon. High colonic tone postoperatively may be relevant for p harmacologic treatment of postoperative ileus.