Document Detail

Vascular flow of the gastric fundus after arterial devascularization: an experimental study.
MedLine Citation:
PMID:  18805545     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The main complication of transhiatal subtotal esophagectomy with esophagogastric reconstruction is anastomotic leak, which is responsible for a large number of postoperative deaths. It is believed that this complication is due to gastric fundus ischemia caused by the sectioning of the short gastric, left gastric, and left gastro-omental arteries. The literature, however, presents controversies. An experimental study was performed with the aim of evaluating the vascularization of the gastric fundus following sectioning of these arteries. MATERIALS AND METHODS: Forty mongrel dogs were distributed into 2 groups: a control group consisting of 15 dogs subjected to surgical simulation and an experimental group consisting of 25 dogs that underwent sectioning of these arteries. Fluorescein testing, gastric mummification, and morphometric image analysis were performed on both groups. RESULTS: In comparison with the control group, fluorescein testing on the experimental group demonstrated time-delayed fluorescence in the gastric fundus and partial coloring, (P < 0.001). Image analysis on the mummified gastric samples demonstrated significant reduction in blood vessels in the gastric fundus of the experimental group (P < 0.001). CONCLUSIONS: We conclude that sectioning of the short gastric, left gastric, and left gastro-omental arteries causes reduction in blood circulation and in the quantity of blood vessels on the anterior side of the gastric fundus of dogs.
Marise Gomes; Eduardo Ramacciotti; Fausto Miranda; Alexandre Cruz Henriques; Djalma José Fagundes
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Publication Detail:
Type:  Journal Article     Date:  2008-05-07
Journal Detail:
Title:  The Journal of surgical research     Volume:  152     ISSN:  1095-8673     ISO Abbreviation:  J. Surg. Res.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-11-03     Completed Date:  2009-12-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376340     Medline TA:  J Surg Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-34     Citation Subset:  IM    
Fifty Medical Research, São Paulo, Brazil.
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MeSH Terms
Anastomosis, Surgical / adverse effects
Arteries / surgery
Esophagectomy / adverse effects*
Gastric Fundus / blood supply*
Ischemia / etiology*

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