Sökning: onr:"swepub:oai:DiVA.org:uu-308550" > Perfusion of the ga...
Fältnamn | Indikatorer | Metadata |
---|---|---|
000 | 03194naa a2200325 4500 | |
001 | oai:DiVA.org:uu-308550 | |
003 | SwePub | |
008 | 161128s2017 | |||||||||||000 ||eng| | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3085502 URI |
024 | 7 | a https://doi.org/10.1111/dote.125372 DOI |
040 | a (SwePub)uu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Linder, Gustavu Uppsala universitet,Gastrointestinalkirurgi4 aut0 (Swepub:uu)gulin499 |
245 | 1 0 | a Perfusion of the gastric conduit during esophagectomy |
264 | c 2016-10-21 | |
264 | 1 | b Oxford University Press (OUP),c 2017 |
338 | a print2 rdacarrier | |
520 | a In esophageal cancer surgery, perfusion of the gastric conduit is a critical issue. Measurement of gastric intramucosal pH (pHi ) is a method to identify anaerobic metabolism as a sign of impaired perfusion. In this study we aimed to monitor changes in the perfusion of the gastric conduit at key steps during and after esophagectomy. pHi was measured per- and postoperatively using intermittent gastric tonometry in 32 patients undergoing open, 65%, or video-assisted thoracoscopic esophagectomy for esophageal cancer. Measurements focused on the surgical steps when the vascular supply to the gastric conduit was altered. A tonometry catheter was successfully placed in all patients and a decrease in pHi (mean ± SD) was observed from baseline to after the division of the short gastric vessels (7.33 ± 0.07 to 7.29 ± 0.07, P = 0.005). A further reduction after the ligation of the left gastric artery (7.26 ± 0.08, P < 0.001) and after final linear stapling the gastric conduit (7.15 ± 0.13, P < 0.001) was observed. Two hours after surgery, pHi increased (7.24 ± 0.09, P = 0.002). In contrast to open surgery, a trend towards less reduction in pHi was seen in thoracoscopic surgery. Patients with anastomotic leaks had lower pHi on the first postoperative day (7.12 ± 0.05 vs. 7.27 ± 0.08, P = 0.040). It can be concluded that each surgical step altering the vascular supply to the gastric conduit resulted in detectable changes, however transient, in pHi . Patients with low pHi on the first postoperative day were more prone to have clinically relevant anastomotic leaks. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Gastroenterologi0 (SwePub)302132 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Gastroenterology and Hepatology0 (SwePub)302132 hsv//eng |
700 | 1 | a Hedberg, Jakob,d 1972-u Uppsala universitet,Gastrointestinalkirurgi4 aut0 (Swepub:uu)jakhe890 |
700 | 1 | a Björck, Martinu Uppsala universitet,Kärlkirurgi4 aut0 (Swepub:uu)mabjo425 |
700 | 1 | a Sundbom, Magnusu Uppsala universitet,Gastrointestinalkirurgi4 aut0 (Swepub:uu)magsundb |
710 | 2 | a Uppsala universitetb Gastrointestinalkirurgi4 org |
773 | 0 | t Diseases of the esophagusd : Oxford University Press (OUP)g 30:1, s. 143-149q 30:1<143-149x 1120-8694x 1442-2050 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308550 |
856 | 4 8 | u https://doi.org/10.1111/dote.12537 |
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