Preoperative laparoscopic ligation of the left gastric vessels in preparation for esophagectomy.
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.
Nguyen
Ninh T
NT
Department of Surgery and Medicine, University of California Irvine Medical Center, Orange, California, USA. ninhn@uci.edu
Longoria
Mario
M
Sabio
Allen
A
Chalifoux
Sara
S
Lee
John
J
Chang
Ken
K
Wilson
Samuel E
SE
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*