CHANGES IN GASTRIC TISSUE OXYGENATION DURING MOBILIZATION FOR ESOPHAGEAL REPLACEMENT

We have measured changes in gastric tissue oxygen tension (PtO2,mmHg), with a modified Clark oxygen electrode, in eight patients (median age 59 years, range 52 to 74) undergoing oesophagectomy for carcinoma. Op erations were performed with a cervical anastomosis and the stomach mo bilised on the right gastric and gastroepiploic arteries. Tissue oxyge n tension was measured in the gastric fundus at 4 points: (1) before m obilisation, (2) after mobilisation with the stomach in the abdomen, ( 3) with the fundus lifted to the neck and (4) after anastomosis. From a mean of 77 mmHg before mobilisation, PtO2 was halved to 36 mmHg afte r mobilisation with no further fall after transposition to the neck or anastomosis. Arterial oxygen concentration (PaO2), mean arterial pres sure (MAP) and oxygen delivery (DO2) were similar at each point. Tissu e oxygen tension was correlated with PaO2 at points 1 and 4 but MAP on ly at point 1 and DO2 not at all, These findings document the relation ship of gastric PtO2 to mobilisation of the stomach and demonstrate th e important influence of PaO2 on PtO2.