Document Detail

Gastric distention exacerbates ischemia in a rodent model of partial gastric devascularization.
MedLine Citation:
PMID:  9365328     Owner:  NLM     Status:  MEDLINE    
Occult ischemia of the mobilized gastric fundus is an important etiologic factor for esophagogastric anastomotic leaks after esophagectomy. Postoperative gastric distention is another possible predisposing factor for anastomotic leakage. We hypothesized that gastric distention could worsen gastric ischemia. To test this hypothesis, gastric tissue perfusion was studied in 20 Sprague-Dawley rats. Baseline serosal gastric tissue perfusion was measured by laser-Doppler flowmetry at a point 10 mm distal to the gastroesophageal junction. Perfusion was measured after left gastric artery occlusion, gastric distention to 20 cm water pressure, and combined left gastric artery occlusion and gastric distention. Gastric tissue perfusion (in tissue perfusion units, TPU) was 64.2 +/- 9.1 TPU at baseline measurement, 18.6 +/- 4.3 TPU after left gastric artery occlusion, 22.0 +/- 4.1 TPU after gastric distention, and 7.8 +/- 1.8 TPU after combined left gastric artery occlusion and gastric distention. Distention (P < 0.0001) and arterial occlusion (P < 0.0001) both reduced gastric tissue perfusion; of the two, arterial occlusion produced the greatest reduction in perfusion (P < 0.021). The combination of distention and arterial occlusion caused greater reduction in gastric perfusion than either factor alone (P < 0.0001). In this model, gastric distention exacerbated the ischemia produced by partial gastric devascularization. In clinical esophageal surgery, postoperative gastric distention may similarly potentiate the ischemic effects of gastric transposition for esophageal reconstruction.
J D Urschel; J G Antkowiak; H Takita
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of the medical sciences     Volume:  314     ISSN:  0002-9629     ISO Abbreviation:  Am. J. Med. Sci.     Publication Date:  1997 Nov 
Date Detail:
Created Date:  1997-12-09     Completed Date:  1997-12-09     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370506     Medline TA:  Am J Med Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  284-6     Citation Subset:  AIM; IM    
Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, New York 14263-0001, USA.
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MeSH Terms
Anastomosis, Surgical
Disease Models, Animal
Esophagus / surgery
Gastric Dilatation / physiopathology*
Gastric Fundus / blood supply*
Ischemia / etiology*
Postoperative Complications / etiology*
Rats, Sprague-Dawley
Regional Blood Flow
Stomach / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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