Perfusion of the gastric conduit during esophagectomy

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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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Diseases of the esophagus (Sök värdpublikationen i LIBRIS)

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Av författaren/redakt...: Linder, Gustav; Hedberg, Jakob, ...; Björck, Martin; Sundbom, Magnus

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Gastroenterologi

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