Miyoshi H
Nihon Geka Gakkai Zasshi. 1986 May;87(5):499-509.
One of major complications following esophageal reconstruction is anastomotic leakage. It is concerned with suppression of oxygen supply to the stomach roll used for esophageal reconstruction. This study was performed for the purpose of evaluation of oxygen supply to the stomach roll under various circumstances by the measurement of tissue oxygen tension (PtO2) using micro-electrode. PtO2 within muscle layer of normal stomach was 60 mmHg, and that of stomach roll revealed 58% of normal stomach in dog. The decline of PtO2 resulted from suppression of arterial feeding rather than venous congestion. PtO2 in the stomach roll was reduced in hypoxemic condition by decreasing inspired oxygen tension, and did not rise in hyperoxemic condition in dog. PtO2 in the stomach roll was measured in 19 human cases daily until the 7th post-operative day. It was unstable for the early post-operative days, and anastomotic leakage occurred in the cases of which PtO2 revealed under 30 mmHg for the first 5 days. Therefore respiratory and hemodynamic control should be strictly performed for this period to prevent leakage from anastomosis.
食管重建术后的主要并发症之一是吻合口漏。这与用于食管重建的胃管的氧气供应受抑制有关。本研究旨在通过使用微电极测量组织氧分压（PtO2）来评估在各种情况下胃管的氧气供应。正常胃肌层内的PtO2为60 mmHg，而在狗身上，胃管的PtO2显示为正常胃的58%。PtO2的下降是由于动脉供血受抑制而非静脉充血所致。在狗身上，通过降低吸入氧分压，低氧状态下胃管中的PtO2会降低，而在高氧状态下则不会升高。在19例人类病例中，每天测量胃管中的PtO2直至术后第7天。术后早期其不稳定，在前5天PtO2低于30 mmHg的病例中发生了吻合口漏。因此，在此期间应严格进行呼吸和血流动力学控制，以防止吻合口漏。
