[Vascular deficit is the major cause of fistula in esophageal surgery].
OBJECTIVE
The aim of this retrospective study was to find a link between vascularization failure and fistula in esophageal surgery. The originality of this study was to be based on hyperselective arteriogaphy of the artery vascularizing the gastric plasty, showing all vascular network of the plasty.


METHODS
Hyperselective arteriography was carried out in 14 patients operated for esophagus cancer with a gastric plasty replacement. All these patients had a postoperative leakage or a bad vascularization of the gastric plasty during the operation.


RESULTS
The vascularization of the gastric plasty was organized from the gastro-epiploic artery by anastomotic transversal network, depending on the left gastro-epiploic artery and left gastric artery. For the 14 patients, a constant link between leakage and vascularization failure could be proved.


CONCLUSIONS
Esophageal surgery is dependent on the vascular status of the patient. The type of gastric plasty with large or narrow tubulization does not interfere with the quality of vascularization at the top of the plasty due to the preservation of a corporeal low branch.
Khoury-Hélou
A
A
Service de chirurgie digestive, hôpital de la Cavale-Blanche, 29200 Brest, France.
Nonent
M
M
Vandenbrouke
F
F
Topart
P
P
Lozac'h
P
P
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D004937:Esophageal Fistula / Q000209:etiology* / Q000473:pathology; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply / Q000601:surgery*; D013524:Surgical Flaps
Le déficit vasculaire est la cause majeure des fistules en chirurgie oesophagienne.