BACKGROUND: Ischemia may lead to leakage at the esophagogastric anastomosis after esophagectomy. The aim of this study was to investigate time dependent changes of gastric microcirculation after ischemic conditioning. METHODS: Twenty male Lewis rats were used and analyzed in 3 study groups and 1 control group. Group 1 (n = 5) underwent ligation of the left gastric artery and intravital fluorescence microscopy (IVM) on day 0; group 2 (n = 5) underwent IVM at 28 days after ligation of the LGA; and group 3 (n = 5) underwent IVM at 56 days after ligation of the LGA. The controls (n = 5) underwent sham surgery and IVM at 28 days thereafter. IVM was used to analyze gastric microcirculation by means of functional capillary density. RESULTS: Ligation of the LGA immediately led to significant reduction of perfusion at the lesser (100.5 +/- 3.1 microm/mm(2) vs 220.4 +/- 7.4 microm/mm(2); P <.001) and greater curvatures (195.1 +/- 7.9 microm/mm(2) vs 234.1 +/- 9.4 microm/mm(2); P = .013). During 28 days, microcirculation at the lesser curve ameliorated (164.9 +/- 12.8 microm/mm(2)) and reached normal values after 56 days (215.8 +/- 7.4 microm/mm(2)). At the greater curve, microcirculation was improved during 4 (261.3 +/- 8 microm/mm(2)P = .039) and 8 weeks (317.9 +/- 10.3 microm/mm(2); P <.001 vs control). CONCLUSIONS: Gastric microperfusion continuously improves after partial devascularization. The results support further clinical studies to optimize gastric ischemic conditioning in patients undergoing esophagectomy.
BACKGROUND:Ischemia may lead to leakage at the esophagogastric anastomosis after esophagectomy. The aim of this study was to investigate time dependent changes of gastric microcirculation after ischemic conditioning. METHODS: Twenty male Lewis rats were used and analyzed in 3 study groups and 1 control group. Group 1 (n = 5) underwent ligation of the left gastric artery and intravital fluorescence microscopy (IVM) on day 0; group 2 (n = 5) underwent IVM at 28 days after ligation of the LGA; and group 3 (n = 5) underwent IVM at 56 days after ligation of the LGA. The controls (n = 5) underwent sham surgery and IVM at 28 days thereafter. IVM was used to analyze gastric microcirculation by means of functional capillary density. RESULTS: Ligation of the LGA immediately led to significant reduction of perfusion at the lesser (100.5 +/- 3.1 microm/mm(2) vs 220.4 +/- 7.4 microm/mm(2); P <.001) and greater curvatures (195.1 +/- 7.9 microm/mm(2) vs 234.1 +/- 9.4 microm/mm(2); P = .013). During 28 days, microcirculation at the lesser curve ameliorated (164.9 +/- 12.8 microm/mm(2)) and reached normal values after 56 days (215.8 +/- 7.4 microm/mm(2)). At the greater curve, microcirculation was improved during 4 (261.3 +/- 8 microm/mm(2)P = .039) and 8 weeks (317.9 +/- 10.3 microm/mm(2); P <.001 vs control). CONCLUSIONS: Gastric microperfusion continuously improves after partial devascularization. The results support further clinical studies to optimize gastric ischemic conditioning in patients undergoing esophagectomy.
Authors: Hannes Köhler; Boris Jansen-Winkeln; Marianne Maktabi; Manuel Barberio; Jonathan Takoh; Nico Holfert; Yusef Moulla; Stefan Niebisch; Michele Diana; Thomas Neumuth; Sebastian M Rabe; Claire Chalopin; Andreas Melzer; Ines Gockel Journal: Surg Endosc Date: 2019-01-23 Impact factor: 4.584
Authors: Thai H Pham; Shelby D Melton; Patrick J McLaren; Ali A Mokdad; Sergio Huerta; David H Wang; Kyle A Perry; Hope L Hardaker; James P Dolan Journal: J Surg Oncol Date: 2017-05-29 Impact factor: 3.454
Authors: V Prochazka; F Marek; L Kunovsky; R Svaton; T Grolich; P Moravcik; M Farkasova; Z Kala Journal: Ann R Coll Surg Engl Date: 2018-06-18 Impact factor: 1.891
Authors: Vadim Prudius; Vladimír Procházka; Zdeněk Pavlovský; Adam Peštál; Petr Vlček; Ivan Čapov; Lenka Veverková; Michal Reška Journal: Wideochir Inne Tech Maloinwazyjne Date: 2018-05-22 Impact factor: 1.195