OBJECTIVE: To assess the value of relative blood perfusion of the gastric tube in prediction of impaired healing of cervical oesophagogastrostomies. DESIGN: Prospective study. SETTING: University hospital, The Netherlands. SUBJECTS: Thirty patients undergoing transhiatal oesophagectomy and partial gastrectomy for cancer of the oesophagus or oesophagogastric junction, with gastric tube reconstruction and cervical oesophagogastrostomy. MAIN OUTCOME MEASURES: Operative measurement of gastric blood perfusion at four sites by laser Doppler flowmetry and perfusion of the same sites after construction of the gastric tube expressed as a percentage of preconstruction values. RESULTS: The relative perfusion at the most proximal site of the gastric tube was significantly lower than at the more distal sites (p = 0.001). Nine of 18 patients (50%) in whom the perfusion of the proximal gastric tube was less than 70% of preconstruction values developed an anastomotic stricture, compared with only 1 of 12 patients (8%) with a relative perfusion of 70% or more (p = 0.024). A reduction in perfusion of the gastric tube did not predict leakage. CONCLUSION: Impaired anastomotic healing is unlikely if relative perfusion is 70% or more of preconstruction values. Perfusion of less than 70% partly predicts the occurrence of anastomotic stricture, but leakage cannot be predicted. Factors other than blood perfusion may have a role in the process of anastomotic healing.
OBJECTIVE: To assess the value of relative blood perfusion of the gastric tube in prediction of impaired healing of cervical oesophagogastrostomies. DESIGN: Prospective study. SETTING: University hospital, The Netherlands. SUBJECTS: Thirty patients undergoing transhiatal oesophagectomy and partial gastrectomy for cancer of the oesophagus or oesophagogastric junction, with gastric tube reconstruction and cervical oesophagogastrostomy. MAIN OUTCOME MEASURES: Operative measurement of gastric blood perfusion at four sites by laser Doppler flowmetry and perfusion of the same sites after construction of the gastric tube expressed as a percentage of preconstruction values. RESULTS: The relative perfusion at the most proximal site of the gastric tube was significantly lower than at the more distal sites (p = 0.001). Nine of 18 patients (50%) in whom the perfusion of the proximal gastric tube was less than 70% of preconstruction values developed an anastomotic stricture, compared with only 1 of 12 patients (8%) with a relative perfusion of 70% or more (p = 0.024). A reduction in perfusion of the gastric tube did not predict leakage. CONCLUSION: Impaired anastomotic healing is unlikely if relative perfusion is 70% or more of preconstruction values. Perfusion of less than 70% partly predicts the occurrence of anastomotic stricture, but leakage cannot be predicted. Factors other than blood perfusion may have a role in the process of anastomotic healing.
Authors: Kyle A Perry; C Kristian Enestvedt; Thai H Pham; James P Dolan; John G Hunter Journal: J Gastrointest Surg Date: 2010-05-15 Impact factor: 3.452
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: Kyle A Perry; Ambar Banarjee; James Liu; Nilay Shah; Mark R Wendling; W Scott Melvin Journal: Surg Endosc Date: 2012-12-18 Impact factor: 4.584