[Methods for increasing graft survival in esophagogastroplasty]

From their own clinical material the authors revealed that insufficient venous outflow was the main link in the pathogenesis of impaired viability of the pedicle formed from the greater curvature in esophagoplasty. This leads to circulatory disorders in the graft: venous hypertension of up to 34.4 +/- 2.3 cm inadequate perfusion of tissue, and secondary arterial hypotension below 40 mm Hg. The authors suggested an original pathogenetically substantiated method of esophagoplasty with a pedicle from the greater curvature of the stomach. Its essence consists in the creation of an additional venous outflow from the graft into the neck veins. Operations were performed on 55 patients with the formation of 70 intravenous anastomoses. The suggested method made it possible to form a longer graft and reduce considerably the number of necrotic complications in esophagoplasty. A reliable graft of sufficient length allowed the immediate and late-term results of treatment and rehabilitation of patients with esophageal carcinoma to be improved essentially.