Research Of The Connection Between The Measuration Of Change Of Stomach Serosa Blood Flow And Anastomotic Leakage After Esophagestomy

Objective: Leakage at the anastomotic site in esophageal surgery remains an annoying problem to both patients and thoracic surgeons. We design this clinical experiment to understand the change of tissue blood flow of stomach before and after formation of gastric tube ,to evaluate the influence of measurement of tissue blood flow of different orientation of the stomach fundus in operation ,towards the anastomotic leakage rate after esophagectomy.Methods: Between February 2004 to June 2005 ,233 cases of middle-lower esophageal carcinoma undergoing esophagectomy received mechanical anastomosis . Among them, the tissue blood flow of the different orientation of gastric fundus was measured by making laser Doppler before mobilization and after formation of the gastric tube in 127patients。We choose the anastomotic position which had the best blood flow .Results: No statistically significant differences were observed before mobilization .The mean tissue blood flow fell to 45% -75% after gastuic tube formation. The TBF of behind stomach and largest curvature was significantly higher than the lesser curvature orientation.. There was four anastomotic leakage in the no-measurement group. No anastomotic leakage occurred in the measurement group.Conclusion: Laser Doppler can be used to choose the best anastomotic position in esophageal reconstruction and help to efficiently decrease the anastomotic leakage rate .