[Anastomotic method of the gastro-omental arterial circle: interest in the transillumination method at the gastric esophagoplasty].
The gastroomental (gastroepiploic) arterial circle of the stomach is the main vascular axis of the gastroplasty use as esophagus substitute after esophagectomy. The aim of this anatomoangiographic study is to study the anastomosis between the right and left gastroomental arteries and emphasize interest of the transillumination: an ordinary anatomic method use in surgical practice. We use forty five fresh cadaveric stomach of adult for determine the anastomotic fashion of the arterial circle of the great gastric curvature. About three models of gastric esophagoplasty we verify similarity of vascular transillumination results and we compare with the radiographic exploration. The thickness of the gastrocolic ligament in which progress the gastroomental arterial circle can lead astray for macroscopic determination of anastomotic mode. Thus the type I, II, III and IV which are of 60%, 22,2%, 13,3% and 4,4% at macroscopic observation become 64,1%, 15,4%, 15,4% and 5,1% after arteriographic analysis. Even if the submucosal arteriolar network and the rich parietal anastomosis confer at the stomach the best qualities for esophageal replacement, the multifactorial particularity of success in esophagogastroplasty require identification and preservation of the gastroomental arterial circle. The transillumination which facilitate evaluation of this arterial axis is a simple and accessible process which we advocate.
Laboratoire d'Anatomie et d'Organogenèse, Faculté de Médecine, Université Cheikh Anta Diop, Dakar, Sénégal. jmndoye04@yahoo.fr
J M
JM
Ndoye
J
J
Savadogo
A
A
Ndiaye
M
M
Diop
L
L
Mané
A
A
Ndiaye
A
A
Dia
P S
PS
Diop
B
B
Fall
M L
ML
Sow
D002102:Cadaver; D016629:Esophagectomy / Q000379:methods; D004944:Esophagoplasty / Q000379:methods*; D004947:Esophagus / Q000098:blood supply*; D024405:Gastroepiploic Artery / Q000601:surgery*; D006801:Humans