Vascularizing the ischemic jejunum by intra-seromuscular implantation of a gastroepiploic vascular pedicle--an application of experimental esophageal reconstruction.

Many experimental studies have been done in an attempt to feed various ischemic organs. Of these, both direct intraorganic vascular implantation, and vascular anastomosis, appear to show promise for vascularizing the ischemic gastrointestinal tracts. Preliminary experiments were done in 24 Mongrel dogs to establish the blood flow of the jejunum by direct epiploic vascular pedicle implantation. Morphological development of the communicating vascular system, newly formed between the implanted epiploic vessel and the indigenous vascular network of the jejunum, was clarified by microangiography and histology. In 20 dogs, esophageal reconstruction was successfully accomplished, using the jejunal loop vascularized as described above. The total length of the jejunal segment, and the esophagojejunal anastomotic portion, had neither signs of circulatory disturbance nor necrosis, one, three and twelve months post-operatively. Our experimental findings suggest that direct vascular implantation is the simplest way to vascularize the ischemic intestinal tract and may also be applicable widely in the field of abdominal surgery.