Document Detail


Intraoperative changes of mucosal pCO2 during gastric tube formation.
MedLine Citation:
PMID:  11685561     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The formation of a gastric tube after esophagectomy with ligation of the left gastric artery and resection of the lesser curvature is associated with microcirculatory changes, especially in the anastomotic region of the fundus. This influences the healing of the esophagogastrostomy. The presented prospective protocol was designed to assess continuous tonometry as a tool to demonstrate microcirculatory changes during gastric tube formation. In 15 patients with esophageal carcinoma, pCO2 of the gastric mucosa (pCO2i) was measured intraoperatively during formation of a gastric tube. This was done by a nasogastric tube with a silicon balloon connected to a Tonocap recirculating gas analyser. pCO2i measurements were compared for a period of 90 min before and after ligation of the left gastric artery and correlated to the corresponding end expiratory pCO2 (pCO2e). In 14 of 15 patients examined (93.3%), an increase of pCO2i after ligation of the left gastric artery was demonstrated. pCO2i (mean+/-SD) before ligation of the left gastric artery (87 measurements: 40.6+/-7.5 mmHg; range, 29-67 mmHg) was significantly lower (P<0.001) compared to the mean pCO2i after ligation of the left gastric artery (88 measurements: 49.1+/-10.2 mmHg; range, 31-79 mmHg). Continuous tonometry is a valid method to detect changes in mucosal pCO2 during gastric tube formation and should be assessed to monitor the gastric interposition graft during the postoperative course.
Authors:
W Schröder; D Stippel; K T Beckurts; M Lacher; C Gutschow; A H Hölscher
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Langenbeck's archives of surgery / Deutsche Gesellschaft für Chirurgie     Volume:  386     ISSN:  1435-2443     ISO Abbreviation:  Langenbecks Arch Surg     Publication Date:  2001 Aug 
Date Detail:
Created Date:  2001-10-30     Completed Date:  2001-12-05     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9808285     Medline TA:  Langenbecks Arch Surg     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  324-7     Citation Subset:  IM    
Affiliation:
Department of Visceral and Vascular Surgery, University of Cologne, Joseph-Stelzmann-Str. 9, 50931 Cologne, Germany. Wolfgang.Schroeder@Uni-Koeln.de
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / surgery
Adult
Aged
Anastomosis, Surgical / adverse effects
Carbon Dioxide / blood*
Carcinoma, Squamous Cell / surgery
Celiac Artery / anatomy & histology,  surgery
Clinical Protocols
Esophageal Neoplasms / surgery
Esophagostomy / adverse effects,  methods*
Female
Gastric Mucosa / blood supply*
Gastrostomy / adverse effects,  methods*
Humans
Ligation / adverse effects
Male
Manometry / methods*
Microcirculation
Middle Aged
Monitoring, Intraoperative / methods*
Wound Healing
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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