Microcirculatory perfusion of the canine esophagus before and after blind longitudinal dissection and thoracoscopic distal transsection.
In the treatment of distal esophageal pathology, surgical mobilization and exteriorization of the thoracic esophagus can be necessary. This may threaten its vascularization. We investigated the effect of longitudinal dissection and distal transsection on the microcirculatory perfusion of the canine esophagus. Esophageal perfusion and muscular oxygenation were investigated in 11 dogs using laser Doppler fluxmetry and oxygen pressure measurements before and up to 2 weeks after longitudinal dissection with and without distal thoracoscopic transsection. Histological examination was performed at the end of the follow-up period. Distal esophageal perfusion was higher than proximal. Longitudinal dissection caused an insignificant reduction, whereas additional transsection significantly lowered esophageal perfusion, which was restored only partially during follow-up. After transsection distal muscular oxygen pressure was also significantly lower than proximal. Histologically, no significant ischemic cell damage was observed. Laser Doppler perfusion measurement is a feasible technique to measure (changes in) microcirculatory circulation of the esophageal wall. This may be useful in clinical settings to monitor the viability of the esophagus after surgical interventions. Distal transsection substantially reduces esophageal perfusion without apparent short-term histological damage.
Department of Surgery, Academic Medical Center, Amsterdam, 1100 DE, The Netherlands. D.Ubbink@amc.uva.nl
D T
DT
Ubbink
M J
MJ
Boom
M J
MJ
Jacobs
J J
JJ
van Lanschot
H
H
Obertop
D000818:Animals; D004210:Dissection; D004285:Dogs; D004947:Esophagus / Q000098:blood supply* / Q000601:surgery*; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation / Q000502:physiology; D010101:Oxygen Consumption; D013906:Thoracoscopy