Clinical significance of tissue blood flow during esophagectomy by laser Doppler flowmetry
Clinical significance of tissue blood flow during esophagectomy by laser Doppler flowmetry
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DOI：
10.1067/mtc.2001.117835
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发表时间：
2001-12-01
影响因子：
6
通讯作者：
Kodaira, S
中科院分区：
文献类型：
--
作者：
Ikeda, Y;Niimi, M;Kodaira, S
目的：我们试图探讨组织血流对食管癌切除术中吻合口瘘发生率的影响。方法：采用胃管重建，所有病例均涉及颈部吻合。应用激光多普勒血流仪对43例患者在置管前和吻合术后的组织血流进行了测量。结果：吻合口瘘发生后组织血流量为9.1 ± 2.0mL/min/100 g，无吻合口瘘发生后组织血流量为13.7 ± 2.9mL/min/100 g。有渗漏的组织血流量显著低于无渗漏的组织血流量（P <0.01，非配对t检验）。吻合后组织血流量大于13 mL/min/100 g者21例，无吻合口漏发生，组织血流量小于10 mL/min/100 g者5例，均发生吻合口漏。吻合术后组织血流量低可能需要适当的手术或药物干预来检测、定位和抵消渗漏。
Objectives: We sought to investigate the effect of tissue blood flow on the incidence of anastomotic leakage during esophagectomy.Methods: Reconstruction was done with a gastric tube, and all cases involved cervical anastomosis. Tissue blood flow of 43 patients was measured with a laser Doppler flowmeter before emplacement and after anastomosis during surgical intervention. The reconstruction route and tissue blood flow before emplacement and that after anastomosis were analyzed as possible factors influencing anastomotic leakage.Results: Tissue blood flow after anastomosis with leakage was 9.1 +/- 2.0 mL/min per 100 g, and that without leakage was 13.7 +/- 2.9 mL/min per 100 g. Tissue blood flow with leakage was significantly lower than that without leakage (P < .01, unpaired t test). Twenty-one patients had tissue blood flow after anastomosis of greater than 13 mL/min per 100 g, and none of them had leakage, whereas 5 patients had blood flow of less than 10 mL/min per 100 g, and all 5 had leakage.Conclusion: Tissue blood flow can be an important and useful indicator of the presence of current anastomotic leakage. Low tissue blood flow after anastomosis may mediate for appropriate surgical or pharmacologic interventions to detect, localize, and counteract leakage.