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Tissue-Engineered Graft for Circumferential Esophageal Reconstruction in Rats
Published on: February 10, 2020
[Preservative measures for blood supply to jejunal segment in reconstruction of esophagus]
Qiang Sun1, Chun-shan Ma, Zhen-quan Duan
1Department of Thoracic-Cardiovascular Surgery, 401st Hospital of PLA, Qingdao, Shandong, P. R. China, 266071.
Objective:
To study the effective protective measures to ensure sufficient blood supply to the jejunal segment in reconstruction of esophagus.
Methods:
According to evidence based on medicine, we analyzed retrospectively 69 patients (48 cicatricial stenosis due to chemical burn, 21 defects due to excision of esophagus cancer), whose esophagus were reconstructed with free jejunal graft(in 28 cases) and with pedicle jejunal graft (in 41 cases) from 1980 to 2001.
Results:
All patients were followed up for 1-21 years. Of 43 patients treated before 1996, 5 complicated by anastomotic leakage, 1 by strangulated intestinal obstruction; of 26 patients treated after 1996 (6 with free jejunal graft, 20 with pedicle jejunal graft), only one case complicated by anastomotic leakage.
Conclusion:
The preservative measures for good blood supply to the jejunal segment include the following aspects: (1) complete marginal vascular arcade without tension in the mesojejunum; (2) vessel anastomosis smooth; (3) 4-finger width pathway of jejunum; (4) the stable arterial blood pressure (more than 8 kPa); (5) a single-row anastomosis; and (6) the comprehensive preoperative management.
