title: A reduced gastric corpus microvascular blood flow during Ivor-Lewis esophagectomy detected by laser speckle contrast imaging technique.
abstract: BACKGROUND
  Reduced microvascular blood flow is related to anastomotic insufficiency following esophagectomy, emphasizing a need for intraoperative monitoring of the microcirculation. This study evaluated if laser speckle contrast imaging (LSCI) was able to detect intraoperative changes in gastric microcirculation.
  
  
  METHODS
  Gastric microcirculation was assessed prior to and after reconstruction of gastric continuity in 25 consecutive patients operated for adenocarcinoma with open Ivor-Lewis esophagectomy while hemodynamic variables were recorded.
  
  
  RESULTS
  During upper laparotomy, microcirculation at the corpus decreased by 25% from baseline to mobilization of the stomach (p = .008) and decreased further (to a total decrease of 40%) following gastric pull to the thorax (p = .013). On the other hand, microcirculation at the antrum did not change significantly after gastric mobilization (p = .091). The decrease in corpus microcirculation took place unrelated to central cardiovascular variables.
  
  
  CONCLUSIONS
  Using LSCI technique, we identified a reduced microcirculation at the corpus area during open Ivor-Lewis esophagectomy. LSCI provides an option for real-time assessment of gastric microcirculation and could form basis for intraoperative stabilization of the microcirculation.
authors.affiliation: a Department of Surgical Gastroenterology , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Rikard
authors.initials: R
authors.lastname: Ambrus
authors.affiliation: a Department of Surgical Gastroenterology , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Lars B
authors.initials: LB
authors.lastname: Svendsen
authors.affiliation: b Department of Anesthesiology 2043 , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Secher
authors.affiliation: b Department of Anesthesiology 2043 , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Rünitz
authors.affiliation: b Department of Anesthesiology 2043 , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Hans-Jørgen
authors.initials: HJ
authors.lastname: Frederiksen
authors.affiliation: c Copenhagen Academy for Medical Education and Simulation (CAMES) , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Morten B S
authors.initials: MB
authors.lastname: Svendsen
authors.affiliation: d Department of Thoracic Surgery , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Mette
authors.initials: M
authors.lastname: Siemsen
authors.affiliation: a Department of Surgical Gastroenterology , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Steen C
authors.initials: SC
authors.lastname: Kofoed
authors.affiliation: a Department of Surgical Gastroenterology , Rigshospitalet , Copenhagen , Denmark.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Achiam
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003287:Contrast Media / Q000494:pharmacology; D003718:Denmark; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008833:Microcirculation; D018613:Microscopy, Confocal; D018715:Microscopy, Video; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D011446:Prospective Studies; D012039:Regional Blood Flow; D012044:Regression Analysis; D013270:Stomach / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000601:surgery
chemical_list: D003287:Contrast Media
keywords: Gastric microcirculation; Ivor-Lewis esophagectomy; intraoperative monitoring; laser speckle contrast imaging