Preoperative gastric conditioning in cervical gastroplasty

Area of Science:

• Gastroenterology
• Vascular Surgery
• Surgical Oncology

Background:

• Cervical gastroplasty is a complex procedure with potential for significant complications.
• Anastomotic failure, morbidity, and mortality are key concerns in gastroplasty outcomes.
• Ischemic conditioning is being explored as a method to improve surgical outcomes.

Purpose of the Study:

• To evaluate the efficacy of ischemic conditioning of the stomach in reducing complications associated with cervical gastroplasty.
• To assess the impact of preoperative selective arterial embolization on morbidity, mortality, and anastomotic failure rates.

Main Methods:

• A retrospective analysis of 39 patients undergoing cervical gastroplasty.
• Ischemic conditioning was achieved via selective embolization of the left gastric, right gastric, and splenic arteries.
• Surgery was performed two weeks post-embolization, with outcomes including morbidity, mortality, and anastomotic leak rates meticulously recorded.

Main Results:

• The study included 33 patients who completed the procedure after embolization.
• The overall mortality rate was 6%, with one case (3%) of anastomotic leak.
• The most frequent morbidity was respiratory; five patients required reoperation, and the mean hospital stay was 17.5 days.

Conclusions:

• Preoperative embolization is a feasible technique with acceptable morbidity and a short hospital stay post-conditioning.
• This approach appears to reduce the incidence of morbidity, mortality, and anastomotic leaks in cervical gastroplasties.
• Further prospective studies are warranted to validate the effectiveness of ischemic conditioning in this surgical context.