Sökning: onr:"swepub:oai:DiVA.org:uu-308550" >
Perfusion of the ga...
-
Linder, GustavUppsala universitet,Gastrointestinalkirurgi
(författare)
Perfusion of the gastric conduit during esophagectomy
- Artikel/kapitelEngelska2017
Förlag, utgivningsår, omfång ...
-
2016-10-21
-
Oxford University Press (OUP),2017
-
printrdacarrier
Nummerbeteckningar
-
LIBRIS-ID:oai:DiVA.org:uu-308550
-
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-308550URI
-
https://doi.org/10.1111/dote.12537DOI
Kompletterande språkuppgifter
-
Språk:engelska
-
Sammanfattning på:engelska
Ingår i deldatabas
Klassifikation
-
Ämneskategori:ref swepub-contenttype
-
Ämneskategori:art swepub-publicationtype
Anmärkningar
-
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.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
-
Hedberg, Jakob,1972-Uppsala universitet,Gastrointestinalkirurgi(Swepub:uu)jakhe890
(författare)
-
Björck, MartinUppsala universitet,Kärlkirurgi(Swepub:uu)mabjo425
(författare)
-
Sundbom, MagnusUppsala universitet,Gastrointestinalkirurgi(Swepub:uu)magsundb
(författare)
-
Uppsala universitetGastrointestinalkirurgi
(creator_code:org_t)
Sammanhörande titlar
-
Ingår i:Diseases of the esophagus: Oxford University Press (OUP)30:1, s. 143-1491120-86941442-2050
Internetlänk
Hitta via bibliotek
Till lärosätets databas