[Delay phenomenon of the jejunum. Studies of nutritional blood supply and oxygen supply of the jejunum of the rabbit].
BACKGROUND
Delay procedure has been shown to effectively improve microvascular perfusion in skin flaps. In analogy to skin, we have analyzed the effect of delay on regional blood flow and surface tissue PO2 of a proximal segment of the jejunum.


METHODS
Under nembutal anesthesia (30 mg/kg BW) and mechanical ventilation a total of 15 rabbits were laparotomized. Regional blood flow of the jejunum was estimated using radioactive-labeled microspheres, and tissue PO2 was assessed by means of a platinum-multiwire surface electrode. In order to induce acute ischemia three consecutive jejunal arteries were ligated, and the proximal marginal vascular arch was temporarily occluded by a microvascular clip. Delay procedure was induced by 1) ligation of the jejunal arteries, 2) in situ-maintenance of the jejunal segment for two weeks followed by 3) relaparotomy and occlusion of the proximal marginal arch (n = 8). Regional blood flow of the jejunum and tissue PO2 were also assessed in sham-operated animals (n = 7).


RESULTS
After acute ischemia regional blood flow (0.27 (0.05) ml x min-1 x g-1, mean (SEM)) and surface tissue PO2 (39 (3) mmHg) of the jejunal segment were found significantly (p < 0.05) reduced as compared to baseline (0.82 (0.12) ml x min-1 x g-1 and 66 (1) mmHg) and sham-operated animals (0.69 (0.12) ml x min-1 x g-1 and 62 (5) mmHg), respectively. In contrast, delay of the jejunal segment resulted in almost complete preservation of regional blood flow (0.56 (0.04) ml x min-1 x g-1) and surface tissue PO2 (65 (1) mmHg).


CONCLUSIONS
We therefore like to propose that the jejunal delay phenomenon may be clinically used to reduce ischemic complications in jejunal transposition for esophagoplasty.
Vollmar
B
B
Institut für Chirurgische Forschung, Ludwig-Maximilians-Universität, München.
Corleta
O
O
Habazettl
H
H
Kreimeier
U
U
Menger
M D
MD
D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D003106:Colon / Q000098:blood supply; D004734:Energy Metabolism / Q000502:physiology*; D016629:Esophagectomy; D004944:Esophagoplasty; D007511:Ischemia / Q000503:physiopathology; D007583:Jejunum / Q000098:blood supply* / Q000601:surgery; D010101:Oxygen Consumption / Q000502:physiology*; D011817:Rabbits; D012039:Regional Blood Flow / Q000502:physiology; D013270:Stomach / Q000098:blood supply
Delay-Phänomen am Jejunum. Untersuchungen zur nutritiven Durchblutung und Sauerstoffversorgung des Jejunums am Kaninchen.