PREOPERATIVE EMBOLIZATION OF GASTRIC ARTERIES FOR ESOPHAGEAL CANCER

Background. We developed a novel treatment of preoperative embolizatio n therapy in an attempt to prevent anastomotic leakage after esophagea l resection. We report the results of this new treatment. Methods. Pre operative embolization therapy (PET) was performed in 24 cases of esop hageal carcinoma. The femoral artery was punctured, and celiac angiogr aphy was performed. The left gastric artery and splenic artery underwe nt embolization. The right gastric artery then underwent embolization at a site beyond the second or third branch to the gastric wall. With a laser flow meter the stomach tissue blood flow was measured before a nd after construction of the gastric tube, and the change in blood flo w was compared. Results. The average decrease in gastric blood flow wa s 23% in patients with PET and 65% in patients without PET. Twenty-one (88%) of 24 cases maintained more than 50% tissue blood flow in patie nts with PET and in 1 (8%) of 12 in patients without PET (p < 0.001 by t test). No serious complications occurred. Conclusion. Preoperative embolization therapy is a safe and uncomplicated technique, and tissue blood flow in the stomach was better preserved. This new technique is expected to reduce the frequency of anastomotic leakage after esophag eal operation.