[Experimental and clinical studies on the viability of the stomach roll for esophageal reconstruction]

One of major complications following esophageal reconstruction is anastomotic leakage. It is concerned with suppression of oxygen supply to the stomach roll used for esophageal reconstruction. This study was performed for the purpose of evaluation of oxygen supply to the stomach roll under various circumstances by the measurement of tissue oxygen tension (PtO2) using micro-electrode. PtO2 within muscle layer of normal stomach was 60 mmHg, and that of stomach roll revealed 58% of normal stomach in dog. The decline of PtO2 resulted from suppression of arterial feeding rather than venous congestion. PtO2 in the stomach roll was reduced in hypoxemic condition by decreasing inspired oxygen tension, and did not rise in hyperoxemic condition in dog. PtO2 in the stomach roll was measured in 19 human cases daily until the 7th post-operative day. It was unstable for the early post-operative days, and anastomotic leakage occurred in the cases of which PtO2 revealed under 30 mmHg for the first 5 days. Therefore respiratory and hemodynamic control should be strictly performed for this period to prevent leakage from anastomosis.