[Experimental studies on blood flow in the gastric tube for esophageal reconstruction]

Various types of gastric tubes for esophageal substitute were constructed and their advantages and disadvantages were compared. The most important point in esophageal reconstruction is to obtain a gastric tube with sufficient blood supply and with adequate length for the reconstruction. The author constructed 4 types of gastric tube in dogs, that is, whole stomach (A) and gastric tubes with 6 cm (B), 3 cm (C) and 1.5 cm (D) in width respectively, dissecting the lesser curvature side of the stomach to the various extents. The tissue blood flow was measured at the point 3 cm oral from the uppermost pulsation of right gastroepiploic artery using a hydrogen clearance method. The flow rates were found to be 32.8, 30.9, 50.9 and 27.9 ml/min/100 g in gastric tubes A, B, C and D, respectively. It was also found that the blood flow rates in the right gastroepiploic artery were nearly the same in tubes A, B and C, but it decreased remarkably in tube D. Histologic study revealed that the microvasculature of the gastric tube A, B and C was well preserved although that of the tube D was damaged to some extent, resulting in decreased circulation in site. These results clearly indicated that the gastric tube C with 3 cm width is the best choice among the various types of gastric tubes compared, giving adequate blood supply and sufficient length to meet any route in esophageal reconstruction.