Postoperative Monitoring of the Esophageal Gastroplasty Perfusion Rate
Authors:
M. Horáková 1; Č. Neoral 2
Authors place of work:
Oddělení intenzivní péče chirurgických oborů FN Olomouc, primář MUDr. L. Blahut
1; I. chirurgická klinika FN Olomouc, přednosta: doc. MUDr. Č. Neoral, CSc.
2
Published in the journal:
Rozhl. Chir., 2009, roč. 88, č. 1, s. 18-20.
Category:
Monothematic special - Original
Summary
Aim:
Quality assessment of perfusion of the gastric tube after esophagectomy by using the intramucosal pH measurements. Determination, if these measurements may have an early prediction for an anastomotic insufficiency.
Studyn:
Prospective observational study.
Setting place:
Department of surgery (surgical branches) intensive care unit and lst surgical clinic, University hospital Olomouc
Material and Method:
11 patients with the esophageal cancer who underwent esopgagectomy with the replacement by the gastric tube were divided into two groups (leakage+ and leakage- anastomosis). The intramucosal pH (pHi) was measured by a gastric tonometry.
Results:
Patients with anastomotic leakage on early post-operative period (n = 3) had significantly lower values of pHi than patients without anastomotic leakage (n = 8)
Conclusion:
Gastric tonometry is an useful method to evaluate gastric tube perfusion after esophagectomy. The intramucosal pH values significantly correlated with viability of gastric tube. Measurements of pHi is high predictionable of the risk of anastomotic insufficiency on early stage after surgery.
Key words:
esophageal cancer – esophagectomy – gastric tube – anastomotic leakage – gastric tonometry – intramucosal pH
Zdroje
1. Král, V., Neoral Č., Aujeský R. Přednosti a nedostatky krční anastomózy šité pomocí stapleru. Rozhl. Chir., 74, 1995, č. 8, s. 438-440.
2. Neoral, Č., Králík J. Function anatomy of vascular stem of the transposed stokách. Acta Univ. Palacki Olomouc, Fac. Med., 1993, Volume 135, s. 85–87.
3. Neoral, Č., Bártek, J., Čechová, I., Grosmanová, T., Králík J. Monitorování vytypovaných biochemických markem tkáňové ischemie, zejména trávícího traktu v experimentu a klinice. Rozhl. Chir., 76. 1997, č. 12, s. 626–630.
4. Urschel, J. D. Esophagogastrostomy anastomotic leaks complicating esophagetomy: a review. Am. J. Surg., 1995, Jun: 169(6), 634–640.
5. Pierie, J. P., De Graaf, P. W., Poen, H., van der Tweel, I., Obertop, H. Impaired healing of cervical oesophagogastrostomies can be predicted by estimation of gastric serosal blood perfusion by laser Doppler flowmetry. Eur. J. Surg., 1994, Nov; 160(11): 599–603.
6. Neoral, Č., Králík J. Function anatomy of vascular stem of the transposed stomach. Acta Univ. Palacki., Fac. Med., 1993 Vol. 135, 85–87.
7. Schilling, M. K., Mettler, D., Redaelli, C., Büchler, M. W. Circulatory and anatomie differences among experimental gastric tubes as esophageal replacement. World J. Surg., 1997, Nov-Dec; 21(9): 992–997.
8. Černý, V., Cvachovec, K. Gastric tonometry and intramucosal pH – theoretical principles and clinical application. Physiol. res., 2000: 49, 289–297.
9. Clavijo-Alvarez, J. A., Sims, C. A., Menconi, M., Shim, I., Ochoa, C., Puyana, J. C. Bladder mucosa pH and Pco2 as a minimally invasive monitor of hemorrhagic shock and resuscitation. J. Trauma, 2004, Dec; 57(6): 1199–1209; discussion 1209–1210.
10. Kovacs, G. C., Telek, G., Hamar, J., Furesz, J., Regoly-Merei, J. Prolonged intestinal mucosal acidosis is associated with multiple organ failure in human acute pancreatitis: gastric tonometry revisited. World J. Gastroenterol., 2006, Aug 14; 12(30): 4892–4896.
11. Meisner, F. G., Habler, O. P., Kemming, G. I., Kleen, M. S., Pape, A., Messmer, K. Changes in p(i)CO(2) reflect splanchnic mucosal ischaemia more reliably than changes in pH(i) during haemorrhagic shock. Langenbecks Arch. Surg., 2001 Aug; 386(5): 333–338.
12. Tarui, T., Murata, A., Watanabe, Y., Kim, S. P., Inoue, M., Shiozaki, H., Taenaka, N., Monden, M. Earlier prediction of anastomotic insufficiency after thoracic esophagectomy by intramucosal pH. Crit. Care Med., 1999 Sep; 27(9): 2043–2044.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
2009 Číslo 1
- Metamizole at a Glance and in Practice – Effective Non-Opioid Analgesic for All Ages
- Metamizole vs. Tramadol in Postoperative Analgesia
- Spasmolytic Effect of Metamizole
Najčítanejšie v tomto čísle
- Necrotizing Fasciitis – A Rare Complication of Laparoscopic Appendectomy
- Neurogenous Cervical Tumors
- Laparoscopic Splenectomy – Our Experience
- Mid-term Outcomes and Survival Rates in Patients with Radical Retropubic Prostatectomy (RRP) Under Current Czech Healthcare System