Liebermann-Meffert D M, Meier R, Siewert J R
Department of Surgery, Klinikum rechts der Isar, Technische Universität, München, Germany.
Ann Thorac Surg. 1992 Dec;54(6):1110-5. doi: 10.1016/0003-4975(92)90077-h.
This study investigates the actual, as contrasted with the presumed, blood supply of the greater curvature gastric tube commonly used to reconstruct the gullet after esophagogastrectomy. Arterial and venous corrosion casts of this tube were created in 30 cadavers and demonstrated the following: (1) The right gastroepiploic artery is the exclusive conduit of blood in the pedicle. (2) The contribution of the right gastric artery is negligible. (3) Although tributaries of the left gastroepiploic artery are distributed over the central portion of the tube, the connection between the right and left gastroepiploic vessels is minute. (4) The blood supply of the cranial 20% of the greater curvature tube is through a microscopic network of capillaries and arterioles. These findings constitute an anatomical argument for extremely gentle handling of the stomach throughout its mobilization, during construction and positioning of the tube, and during the anastomosis.
本研究调查了在食管胃切除术后常用于重建食管的大弯胃管的实际血供情况，以对比其假定的血供。在30具尸体上制作了该胃管的动脉和静脉铸型，结果如下：（1）胃网膜右动脉是蒂部唯一的血液供应管道。（2）胃右动脉的贡献可忽略不计。（3）虽然胃网膜左动脉的分支分布在胃管的中央部分，但胃网膜右血管和左血管之间的连接很微小。（4）大弯胃管头端20%的血供是通过毛细血管和小动脉的微观网络实现的。这些发现为在整个胃的游离、胃管构建和定位以及吻合过程中极其轻柔地处理胃提供了解剖学依据。
