title: Preoperative laparoscopic ligation of the left gastric vessels in preparation for esophagectomy.
abstract: Anastomotic leak is a major cause for morbidity after esophagectomy. The cause is believed to be ischemia of the gastric conduit. Preoperative embolization of the left gastric vessels in preparation for esophagectomy has been shown to improve collateral blood flow of the gastric conduit and may reduce the frequency of anastomotic dehiscence after esophagectomy. This report describes the technique of laparoscopic division of the left gastric vessels in 9 patients who underwent pre-esophagectomy staging laparoscopy. Our initial experience demonstrates that laparoscopic ligation of the left gastric artery is a safe alternative to embolization and can be performed in conjunction with staging laparoscopy for patients with esophageal cancer.
authors.affiliation: Department of Surgery and Medicine, University of California Irvine Medical Center, Orange, California, USA. ninhn@uci.edu
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: Mario
authors.initials: M
authors.lastname: Longoria
authors.forename: Allen
authors.initials: A
authors.lastname: Sabio
authors.forename: Sara
authors.initials: S
authors.lastname: Chalifoux
authors.forename: John
authors.initials: J
authors.lastname: Lee
authors.forename: Ken
authors.initials: K
authors.lastname: Chang
authors.forename: Samuel E
authors.initials: SE
authors.lastname: Wilson
mesh_terms: D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D003097:Collateral Circulation; D004938:Esophageal Neoplasms / Q000601:surgery; D016629:Esophagectomy; D005260:Female; D005748:Gastric Fundus / Q000098:blood supply; D024405:Gastroepiploic Artery / Q000601:surgery; D046152:Gastrointestinal Stromal Tumors / Q000601:surgery; D006801:Humans; D007511:Ischemia / Q000517:prevention & control; D010535:Laparoscopy / Q000379:methods*; D008026:Ligation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D011300:Preoperative Care; D012189:Retrospective Studies; D013270:Stomach / Q000098:blood supply*