Gomes Marise, Ramacciotti Eduardo, Miranda Fausto, Henriques Alexandre Cruz, Fagundes Djalma José
Fifty Medical Research, São Paulo, Brazil.
J Surg Res. 2009 Mar;152(1):128-34. doi: 10.1016/j.jss.2008.04.016. Epub 2008 May 7.
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.
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.
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).
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.
经裂孔食管次全切除术联合食管胃重建术的主要并发症是吻合口漏，这是导致大量术后死亡的原因。据信，这种并发症是由于切断胃短动脉、胃左动脉和胃网膜左动脉导致胃底缺血所致。然而，文献中存在争议。进行了一项实验研究，旨在评估切断这些动脉后胃底的血管化情况。
40只杂种犬分为2组：对照组15只，接受手术模拟；实验组25只，切断这些动脉。两组均进行了荧光素检测、胃木乃伊化和形态计量图像分析。
与对照组相比，实验组的荧光素检测显示胃底荧光延迟和部分着色（P < 0.001）。对木乃伊化胃样本的图像分析显示实验组胃底血管显著减少（P < 0.001）。
我们得出结论，切断胃短动脉、胃左动脉和胃网膜左动脉会导致犬胃底前侧的血液循环和血管数量减少。
