AI Article Synopsis
- A novel technique for replacing the distal esophagus after resection of the gastroesophageal junction was tested on 16 pigs, divided into two groups based on the location of a gastric tube.
- The tubes, formed from the gastric corpus, varied in length and showed decreased volume and compliance after formation, with significant drops in blood flow immediately after the procedure.
- However, all measurements returned to baseline levels two weeks post-operation, and no leaks were found, suggesting horizontal gastric corpus tubes could be a viable alternative for this surgical replacement.
Article Abstract
Premalignant lesions of the gastroesophageal junction are treated conservatively or by antireflux surgical procedures. We describe a novel technique that replaces the distal esophagus after resection of the gastroesophageal junction. After resection of the gastroesophageal junction, 16 pigs were divided into two groups. In group 1 (n = 9) the gastroesophageal junction was replaced with a 3 cm wide horizontal gastric corpus tube, pedicled at the lesser curvature. In group 2 (n = 7) the tube was pedicled at the greater curvature. Tube length, volume, and compliance of the gastric remnant and blood flow in the tube (by laser Doppler flowmetry given in perfusion units [PU]) were measured before and after tube formation and 2 weeks postoperatively. Group 1 tubes were 9.5 +/- 1. 5 cm long and group 2 tubes were 8.2 +/- 0.7 cm long. Tube formation decreased volume and compliance of the gastric remnant. After tube formation, blood flow at the tip of the tube decreased from 254 PU to 64 +/- 22 PU (group 1) and 87 +/- 36 PU (group 2). Volume, compliance, and blood flow returned to baseline values 2 weeks postoperatively. No anastomotic leakage was found on postmortem examination. Horizontal gastric corpus tubes might offer an alternative to replace the distal esophagus and proximal stomach after resection of premalignant lesions of the gastroesophageal junction.
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| http://dx.doi.org/10.1016/s1091-255x(00)80034-7 | DOI Listing |
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