Abstract
Purpose: The aim of this study was to evaluate the effect of preoperative redistribution of gastric blood supply on the prevention of anastomotic leakage following surgical reconstruction of the esophagus.
Methods: In 37 patients with esophageal carcinoma, transarterial embolization (TAE) of the left gastric, right gastric, and splenic arteries was preoperatively performed with coils so that gastric blood supply was dependent only on the right gastroepiploic artery.
Results: In 34 of 37 patients, preoperative redistribution was successfully performed. The gastric tissue blood flow (TBF) of a gastric tube was higher than in 12 nonredistributed patients. Reduction in the gastric TBF during preparation of a gastric tube was 27.5% in successful patients, in contrast to 68.9% in 12 nonredistributed patients (p<0.005).
Conclusion: Preoperative redistribution by TAE reduced the drop in gastric TBF during preparation of a gastric tube and helped prevent postoperative anastomotic leakage in esophageal reconstruction.
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References
Gurkan N, Terzioglu T, Tezelman S, Samaz O (1991) Transhiatal oesophagectomy for oesophageal carcinoma. Br J Surg 78:1348–1351
Wang LS, Huang MH, Huang BS, Chien KY (1992) Gastric substitution for resectable carcinoma of the esophagus: An analysis of 368 cases. Ann Thoracic Surg 53:289–294
Patil PK, Patil SG, Mistry RC, Deshpande RK, Desai PB (1992) Cancer of the esophagus: Esophagogastric anastomosis leak: A retrospective study of predisposing factors. J Surg Oncol 49:163–167
Lee Y, Fujita H, Yamana H, Kakegawa T (1994) Factors affecting leakage following esophageal anastomosis. Surg Today 24:24–29
Akiyama S, Ito S, Sekiguchi H, Fujiwara M, Sakamoto J, Kondo K, Kasai Y, Ito K, Takagi H (1996) Preoperative embolization of gastric arteries for esophageal cancer. Surgery 120:542–546
Widlus DM, Lammert GK, Brant A, Tsue T, Samphillipo MA Jr, Magee C, Starr FL, Anderson JH, White RI Jr, Russell H (1992) In vivo evaluation of iophendylate-cyanoacrylate mixtures. Radiology 185:269–273
Liebermann-Meffert DMI, Meier R, Siewert JR (1992) Vascular anatomy of the gastric used for esophageal reconstruction. Ann Thorac Surg 54:1110–1115
Miyoshi H (1986) Experimental and clinical studies on the viability of stomach roll for esophageal reconstruction. J Jpn Surg Society 87:499–509
Urschel JD (1995) Esophagogastrostomy anastomotic leaks complicating esophagectomy: A review. Am J Surg 169:634–640
Urschel JD (1995) Ischemic conditioning of the rat stomach: Implications for esophageal replacement with stomach. J Cardiovasc Surg 36:191–193
Hollinshead WH (1971) The stomach, duodenum, pancreas, and spleen. In: Anatomy for Surgeons, Vol. 2. The Thorax, Abdomen, and Pelvis, 1s edn. Harper & Row, New York, pp 381–459
Anderson JH, VuBan A, Wallace S, Hester JP, Burke JS (1977) Transcatheter splenic arterial occlusion: An experimental study in dogs. Radiology 125:95–102
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Isomura, T., Itoh, S., Endo, T. et al. Efficacy of gastric blood supply redistribution by transarterial embolization: Preoperative procedure to prevent postoperative anastomotic leaks following esophagoplasty for esophageal carcinoma. Cardiovasc Intervent Radiol 22, 119–123 (1999). https://doi.org/10.1007/s002709900346
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DOI: https://doi.org/10.1007/s002709900346