Anastomotic and Regional Blood Flow Following Esophagogastrectomy in an Opossum Model

Abstract

Adenocarcinoma of the esophagus is increasing in incidence. The primary treatment is surgical resection, which is associated with considerable risk of anastomotic dehiscence and stricture.Decreased blood flow has been suggested as one of the factors contributing to these anastomotic failures. Our hypothesis was that anastomotic blood flow was decreased secondary to gastric and esophageal mobilization and would be increased by endogenous nitric oxide. Five opossums underwent esophagog astrectomy. Gastric and esophageal blood flow was measured following laparotomy, esophageal and gastric mobilization, esophagog astric resection and anastomosis, and-arginine infusion. RaL dioactive microspheres were used to measure blood flow in the mucosa and muscularis of the esophagog astric anastomosis, esophagus, and stomach. Contrary to our hypothesis, blood flow in the anastomosis was maintained if not increased following esophagog astrectomy. However, the blood flow to the gastric mucosa adjacent to the anastomosis may be decreased. This suggests a possible redistribution of gastric blood flow to supply the anastomosis. If prolonged, this may contribute to poor anastomotic healing. L-Arginine infusion had no effect on blood flow at the anastomosis.

• Esophagus Blood Flow Anastomosis