[Evaluation of tissue oxygenation utilizing a tonometer in the stomach tube or colon used in substitutive esophagus after surgery for esophageal cancer].

We measured serial changes in mucosal pH (pHi) as an index of blood flow of the stomach tube or the colon in a substitutive esophagus using a tonometer in 18 patients following surgery for esophageal cancer. The pHi showed the lowest level at the postoperative 1 hr (PO 1 hr) and increased significantly at PO 6 hr. At PO 12 hr, pHi showed the level of more than pHi 7.3 which increased significantly compared with PO 6 hr. The oxygen delivery and oxygen consumption increased significantly from PO 1 hr at PO 6 hr but not changed between 6 and 12 hr. It was suggested that the blood flow was inadequate in the stomach tube or the colon as a substitutive esophagus within PO 12 hr following operation despite of adequate oxygen delivery systemically. In this series, the decreased pHi were shown in 2 patients with minor leakage of anastomosis and in one patients with the perforation of stomach tube. The correlation between pHi and modified respiratory index was recognized at PO 12 hr and 24 hr suggesting that pHi was associated with the pulmonary dysfunction. Therefore, it was suggested that the value and change of pHi is an useful predicting index of occurrence of anastomotic leakage or respiratory failure which may be a fatal postoperative complication after surgery for esophageal cancer.