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Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses
Background: The microcirculation and oxygen supply at the oesophagogastric anastomosis are crucial factors that influence anastomotic healing after oesophagectomy. Methods: Twenty‐nine patients (mean age 61·7 years) underwent gastric transposition via an orthotopic (14) or retrosternal (15) route. I...
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| Published in: | British journal of surgery 2008-03, Vol.95 (3), p.344-349 |
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| container_end_page | 349 |
| container_issue | 3 |
| container_start_page | 344 |
| container_title | British journal of surgery |
| container_volume | 95 |
| creator | Anegg, U. Lindenmann, J. Maier, A. Smolle, J. Smolle-Jüttner, F. M. |
| description | Background:
The microcirculation and oxygen supply at the oesophagogastric anastomosis are crucial factors that influence anastomotic healing after oesophagectomy.
Methods:
Twenty‐nine patients (mean age 61·7 years) underwent gastric transposition via an orthotopic (14) or retrosternal (15) route. Interstitial partial pressure of oxygen (PO2) of the stomach in the anastomotic region was measured during oesophagectomy and in the intensive care unit. Interstitial PO2 values were determined after ligation of the short gastric vessels, after ligation of the left gastric artery, after forming the conduit and after gastric transposition. Postoperative measurements were recorded during endotracheal intubation, while breathing oxygen by mask or through the nose, and while breathing air.
Results:
Interstitial PO2 levels were significantly higher before ligation of the left gastric artery than after ligation (mean 76·1 (95 per cent confidence interval 54·9 to 103·1) versus 44·9 (24·6 to 77·1) mmHg; P = 0·001). Levels were also higher following orthotopic transposition compared with the retrosternal route (68·2 (44·0 to 118·8) versus 24·6 (10·7 to 39·4) mmHg; P = 0·001) and during each postoperative measurement period. No differences were found between the various oxygen supply systems.
Conclusion:
Oxygen supply at the anastomosis of the gastric conduit reaches higher levels after orthotopic than retrosternal gastric transposition. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Orthotopic route is preferable |
| doi_str_mv | 10.1002/bjs.5997 |
| format | article |
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The microcirculation and oxygen supply at the oesophagogastric anastomosis are crucial factors that influence anastomotic healing after oesophagectomy.
Methods:
Twenty‐nine patients (mean age 61·7 years) underwent gastric transposition via an orthotopic (14) or retrosternal (15) route. Interstitial partial pressure of oxygen (PO2) of the stomach in the anastomotic region was measured during oesophagectomy and in the intensive care unit. Interstitial PO2 values were determined after ligation of the short gastric vessels, after ligation of the left gastric artery, after forming the conduit and after gastric transposition. Postoperative measurements were recorded during endotracheal intubation, while breathing oxygen by mask or through the nose, and while breathing air.
Results:
Interstitial PO2 levels were significantly higher before ligation of the left gastric artery than after ligation (mean 76·1 (95 per cent confidence interval 54·9 to 103·1) versus 44·9 (24·6 to 77·1) mmHg; P = 0·001). Levels were also higher following orthotopic transposition compared with the retrosternal route (68·2 (44·0 to 118·8) versus 24·6 (10·7 to 39·4) mmHg; P = 0·001) and during each postoperative measurement period. No differences were found between the various oxygen supply systems.
Conclusion:
Oxygen supply at the anastomosis of the gastric conduit reaches higher levels after orthotopic than retrosternal gastric transposition. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Orthotopic route is preferable</description><identifier>ISSN: 0007-1323</identifier><identifier>EISSN: 1365-2168</identifier><identifier>DOI: 10.1002/bjs.5997</identifier><identifier>PMID: 17975787</identifier><identifier>CODEN: BJSUAM</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Aged ; Anastomosis, Surgical ; Biological and medical sciences ; Esophageal Diseases - blood ; Esophageal Diseases - surgery ; Esophagectomy - methods ; Female ; Gastrectomy - methods ; General aspects ; Humans ; Intraoperative Care ; Ligation ; Male ; Medical sciences ; Middle Aged ; Oxygen - blood ; Partial Pressure ; Postoperative Complications - etiology ; Stomach - blood supply ; Stomach - transplantation</subject><ispartof>British journal of surgery, 2008-03, Vol.95 (3), p.344-349</ispartof><rights>Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><rights>2008 INIST-CNRS</rights><rights>2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4207-962f3961bca552fb23293d0463920ed58af528e8dc425d54ff412aff0b14b5f43</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20122113$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17975787$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anegg, U.</creatorcontrib><creatorcontrib>Lindenmann, J.</creatorcontrib><creatorcontrib>Maier, A.</creatorcontrib><creatorcontrib>Smolle, J.</creatorcontrib><creatorcontrib>Smolle-Jüttner, F. M.</creatorcontrib><title>Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses</title><title>British journal of surgery</title><addtitle>Br J Surg</addtitle><description>Background:
The microcirculation and oxygen supply at the oesophagogastric anastomosis are crucial factors that influence anastomotic healing after oesophagectomy.
Methods:
Twenty‐nine patients (mean age 61·7 years) underwent gastric transposition via an orthotopic (14) or retrosternal (15) route. Interstitial partial pressure of oxygen (PO2) of the stomach in the anastomotic region was measured during oesophagectomy and in the intensive care unit. Interstitial PO2 values were determined after ligation of the short gastric vessels, after ligation of the left gastric artery, after forming the conduit and after gastric transposition. Postoperative measurements were recorded during endotracheal intubation, while breathing oxygen by mask or through the nose, and while breathing air.
Results:
Interstitial PO2 levels were significantly higher before ligation of the left gastric artery than after ligation (mean 76·1 (95 per cent confidence interval 54·9 to 103·1) versus 44·9 (24·6 to 77·1) mmHg; P = 0·001). Levels were also higher following orthotopic transposition compared with the retrosternal route (68·2 (44·0 to 118·8) versus 24·6 (10·7 to 39·4) mmHg; P = 0·001) and during each postoperative measurement period. No differences were found between the various oxygen supply systems.
Conclusion:
Oxygen supply at the anastomosis of the gastric conduit reaches higher levels after orthotopic than retrosternal gastric transposition. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Orthotopic route is preferable</description><subject>Aged</subject><subject>Anastomosis, Surgical</subject><subject>Biological and medical sciences</subject><subject>Esophageal Diseases - blood</subject><subject>Esophageal Diseases - surgery</subject><subject>Esophagectomy - methods</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>General aspects</subject><subject>Humans</subject><subject>Intraoperative Care</subject><subject>Ligation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Oxygen - blood</subject><subject>Partial Pressure</subject><subject>Postoperative Complications - etiology</subject><subject>Stomach - blood supply</subject><subject>Stomach - transplantation</subject><issn>0007-1323</issn><issn>1365-2168</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNpF0UtPxCAQB3BiNLo-Ej-B6UVvVRhKaY9qXB_xcfB5I7SFFe2W2mnV_fayumpCMnP4MYH5E7LN6D6jFA6KF9wXeS6XyIjxVMTA0myZjCilMmYc-BpZR3yhlHEqYJWsMZlLITM5Iua8sfVgmtJE3kadH_rvZqKx71wZ9Z1usPXoeuebaH4-ZxPTRDi0bT2LdB-Vpnt3pa4jb9C3z3rif-_qJjR-6tHgJlmxukaztagb5H58cnd8Fl_enJ4fH17GZQLhqXkKlucpK0otBNgCOOS8oknKc6CmEpm2AjKTVYGLSiTWJgy0tbRgSSFswjfI3s_ctvNvg8FeTR2Wpq51Y_yASlLOMgEQ4M4CDsXUVKrt3FR3M_W7mAB2F0Bj-J0Neygd_jmgDIAxHlz84z5cbWb_c6iaB6NCMGoejDq6uJ3Xf--wN59_XnevKpVcCvV4farYw9U4fRqDeuRfVzCQGQ</recordid><startdate>200803</startdate><enddate>200803</enddate><creator>Anegg, U.</creator><creator>Lindenmann, J.</creator><creator>Maier, A.</creator><creator>Smolle, J.</creator><creator>Smolle-Jüttner, F. M.</creator><general>John Wiley & Sons, Ltd</general><general>Wiley</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>200803</creationdate><title>Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses</title><author>Anegg, U. ; Lindenmann, J. ; Maier, A. ; Smolle, J. ; Smolle-Jüttner, F. M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4207-962f3961bca552fb23293d0463920ed58af528e8dc425d54ff412aff0b14b5f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Anastomosis, Surgical</topic><topic>Biological and medical sciences</topic><topic>Esophageal Diseases - blood</topic><topic>Esophageal Diseases - surgery</topic><topic>Esophagectomy - methods</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>General aspects</topic><topic>Humans</topic><topic>Intraoperative Care</topic><topic>Ligation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Oxygen - blood</topic><topic>Partial Pressure</topic><topic>Postoperative Complications - etiology</topic><topic>Stomach - blood supply</topic><topic>Stomach - transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anegg, U.</creatorcontrib><creatorcontrib>Lindenmann, J.</creatorcontrib><creatorcontrib>Maier, A.</creatorcontrib><creatorcontrib>Smolle, J.</creatorcontrib><creatorcontrib>Smolle-Jüttner, F. M.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>British journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anegg, U.</au><au>Lindenmann, J.</au><au>Maier, A.</au><au>Smolle, J.</au><au>Smolle-Jüttner, F. M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses</atitle><jtitle>British journal of surgery</jtitle><addtitle>Br J Surg</addtitle><date>2008-03</date><risdate>2008</risdate><volume>95</volume><issue>3</issue><spage>344</spage><epage>349</epage><pages>344-349</pages><issn>0007-1323</issn><eissn>1365-2168</eissn><coden>BJSUAM</coden><abstract>Background:
The microcirculation and oxygen supply at the oesophagogastric anastomosis are crucial factors that influence anastomotic healing after oesophagectomy.
Methods:
Twenty‐nine patients (mean age 61·7 years) underwent gastric transposition via an orthotopic (14) or retrosternal (15) route. Interstitial partial pressure of oxygen (PO2) of the stomach in the anastomotic region was measured during oesophagectomy and in the intensive care unit. Interstitial PO2 values were determined after ligation of the short gastric vessels, after ligation of the left gastric artery, after forming the conduit and after gastric transposition. Postoperative measurements were recorded during endotracheal intubation, while breathing oxygen by mask or through the nose, and while breathing air.
Results:
Interstitial PO2 levels were significantly higher before ligation of the left gastric artery than after ligation (mean 76·1 (95 per cent confidence interval 54·9 to 103·1) versus 44·9 (24·6 to 77·1) mmHg; P = 0·001). Levels were also higher following orthotopic transposition compared with the retrosternal route (68·2 (44·0 to 118·8) versus 24·6 (10·7 to 39·4) mmHg; P = 0·001) and during each postoperative measurement period. No differences were found between the various oxygen supply systems.
Conclusion:
Oxygen supply at the anastomosis of the gastric conduit reaches higher levels after orthotopic than retrosternal gastric transposition. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Orthotopic route is preferable</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>17975787</pmid><doi>10.1002/bjs.5997</doi><tpages>6</tpages></addata></record> |
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| ispartof | British journal of surgery, 2008-03, Vol.95 (3), p.344-349 |
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| language | eng |
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| source | Oxford Journals Online |
| subjects | Aged Anastomosis, Surgical Biological and medical sciences Esophageal Diseases - blood Esophageal Diseases - surgery Esophagectomy - methods Female Gastrectomy - methods General aspects Humans Intraoperative Care Ligation Male Medical sciences Middle Aged Oxygen - blood Partial Pressure Postoperative Complications - etiology Stomach - blood supply Stomach - transplantation |
| title | Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses |
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