[The determination of the level of resection of the esophagus taking into account its blood supply].
Inadequate blood supply is one of the major reasons of esophageal anastomosis incompetence. The authors have examined esophageal blood supply as regards of the operative technique. The esophageal vascular system was studied by the method of intraarterial impregnation in 40 cadavers. Two segments, crucial for esophageal anastomosis, have been determined: retropericardial segment in case of the lower esophageal artery ligation and the upper segment of the thoracic esophagus in case of its extreme mobilization in proximal direction and ligation of lower thyroid arteries. The results of 175 operations were analysed. The direct correlation between the frequency of anastomotic incompetence and the level of its formation was determined. In the zone with an inadequate blood supply the complication occurred in 4 patients of 25 (16%). In other cases the rate of incompetence was 3.2%. No cases of incompetence were observed in 61 patients after anastomosis was performed with due regard for esophageal blood supply.
Miroshnikov
B I
BI
Labazanov
M M
MM
Kalivo
E A
EA
Pavelets
K V
KV
D000328:Adult; D000714:Anastomosis, Surgical / Q000379:methods; D001158:Arteries / Q000601:surgery; D016629:Esophagectomy / Q000379:methods*; D004947:Esophagus / Q000098:blood supply*; D005743:Gastrectomy; D006801:Humans; D008026:Ligation / Q000379:methods; D013529:Surgical Wound Dehiscence / Q000453:epidemiology