[Experimental and clinical studies on esophageal hemodynamics in the Sugiura procedure]

Changes of esophageal hemodynamics in Sugiura procedure were studied. Fifty mongrel dogs were used for the experiment in which esophageal tissue blood flow and oxygen saturation (STO2) were measured. The above parameters showed a decrease of 56% and 10%, respectively, in the lower esophagus following the paraesophageal devascularization versus 18% and 8% after the esophageal transection. Eighty-six patients with esophageal varices were clinically studied. Significant decreasing of the STO2 level in abdominal esophagus was recognized in the group performed the paraesophago-gastric devascularization, compared with the group performed the paraesophageal devascularization. However, decreasing rate was similar at the level of the hiatus in both groups, 22% versus 21%. The STO2 level of the intrathoracic esophagus was lower in both groups as well. Thus, the paragastric devascularization appeared to have caused no effect on intrathoracic esophageal hemodynamics. A significant decrease of the STO2 level was noted in the region immediately below the site of the esophageal transection in a group performed the paraesophago-gastric devascularization. Since this was conceivably attributable to the blockage of esophageal blood flow on the oral side, it may be advisable to perform the esophageal transection a little below the level of the hiatus after the paraesophago-gastric devascularization.