[An experimental study on the hemodynamics of the gastric tube for esophageal reconstruction]. 1991

T Mori
1st Department of Surgery, Faculty of Medicine, Kyoto University.

Though gastric tubes are most frequently used for reconstruction of esophagus, high rate of suture insufficiency at the site of anastomosis including minor leakage still remains as a nuisance problem. As causes for suture insufficiency at the site of anastomosis, not only systemic factors such as hypoproteinemia, pulmonary function disorder, etc. but also local factors such as insufficient blood flow in gastric tube, mechanical tension on the suture site, etc. have been pointed out. The author studied hemodynamics of the gastric tube in mongrel dogs under various conditions in detail with hydrogen gas clearance method and obtained the following results. 1. When gastric tube of greater curvature with diameter of about 3 cm (hereinafter referred to as gastric tube) is made from the whole gastric tube of one dog, tissue blood flow of the oral end of the gastric tube increased by 76%. 2. When tension of 500 g was loaded to the gastric tube in the direction toward head, tissue blood flow of the oral end of the gastric tube decreased by 12%. 3. When the gastric tube was incised circumferentially through seromuscular layer, tissue blood flow of the oral end of the gastric tube made no remarkable change. 4. In the gastric tube, measurement of tissue blood flow was possible from the terminal pulsating branch of the right gastroepiploic artery for 6 cm toward the oral site. Tissue blood flow decreased as the site of measurement became closer to the oral edge of the gastric tube in proportion to the distance. In the cases whose sutures were performed at 3 cm and 4.5 cm oral from the terminal pulsating branch of the right gastroepiploic artery, any leakage was not seen. However in 2 cases of 5 whose sutures were performed at 6 cm, leakages were observed. 5. When sympathetic nerve around the common hepatic artery was removed, tissue blood flow of the gastric tube increased as much as 53%. 6. In cases whose sympathetic nerve were untouched, tissue blood flow of the oral end of the gastric tube was measured everyday for one week after the operation. For three days after operation, the blood flow remained low but from the 4th postoperative day it gradually increased and on the 7th postoperative day it was about 45% of that of preoperative stomach and 124% of that at the time of the gastric tube preparation. 7. In cases with sympathetic nerve resection, the tissue blood flow of the oral end of the gastric tube was observed for one week after operation.(ABSTRACT TRUNCATED AT 400 WORDS)

UI MeSH Term Description Entries
D012039 Regional Blood Flow The flow of BLOOD through or around an organ or region of the body. Blood Flow, Regional,Blood Flows, Regional,Flow, Regional Blood,Flows, Regional Blood,Regional Blood Flows
D001810 Blood Volume Volume of circulating BLOOD. It is the sum of the PLASMA VOLUME and ERYTHROCYTE VOLUME. Blood Volumes,Volume, Blood,Volumes, Blood
D002940 Circadian Rhythm The regular recurrence, in cycles of about 24 hours, of biological processes or activities, such as sensitivity to drugs or environmental and physiological stimuli. Diurnal Rhythm,Nyctohemeral Rhythm,Twenty-Four Hour Rhythm,Nycthemeral Rhythm,Circadian Rhythms,Diurnal Rhythms,Nycthemeral Rhythms,Nyctohemeral Rhythms,Rhythm, Circadian,Rhythm, Diurnal,Rhythm, Nycthemeral,Rhythm, Nyctohemeral,Rhythm, Twenty-Four Hour,Rhythms, Circadian,Rhythms, Diurnal,Rhythms, Nycthemeral,Rhythms, Nyctohemeral,Rhythms, Twenty-Four Hour,Twenty Four Hour Rhythm,Twenty-Four Hour Rhythms
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D004944 Esophagoplasty A plastic operation on the esophagus. (Dorland, 28th ed) Esophagoplasties
D006439 Hemodynamics The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM. Hemodynamic
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013270 Stomach An organ of digestion situated in the left upper quadrant of the abdomen between the termination of the ESOPHAGUS and the beginning of the DUODENUM. Stomachs
D013564 Sympathetic Nervous System The thoracolumbar division of the autonomic nervous system. Sympathetic preganglionic fibers originate in neurons of the intermediolateral column of the spinal cord and project to the paravertebral and prevertebral ganglia, which in turn project to target organs. The sympathetic nervous system mediates the body's response to stressful situations, i.e., the fight or flight reactions. It often acts reciprocally to the parasympathetic system. Nervous System, Sympathetic,Nervous Systems, Sympathetic,Sympathetic Nervous Systems,System, Sympathetic Nervous,Systems, Sympathetic Nervous

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