Intra-operative measurement of the tissue blood flow for evaluating blood supply to the gastric tube for esophageal reconstruction.

BACKGROUND/AIMS: Anastomotic leakage after esophageal surgery is still the main reason for post-operative morbidity and mortality. We developed a reliable procedure for evaluating blood supply to the gastric tube after esophageal reconstruction.

METHODOLOGY

After construction of the gastric tube, tissue blood flow was measured intra-operatively at the anastomotic sites using laser Doppler flowmetry.

RESULTS

There was a distinct difference in tissue blood flow at the distal portion of the gastric tube. The tissue blood flow at the sites of attempted anastomosis was considerably decreased compared to the value of the gastric body (control site).

CONCLUSIONS

By measuring tissue blood flow at the attempted anastomotic site intra-operatively using laser Doppler flowmetry, a sufficiently nourished gastric tube could be prepared. It was our hypothesis that total elimination of the ischemic portion would make esophagogastric anastomosis safer and more reliable.