Preoperative embolization therapy for esophageal operation

Background and Objectives: Since 1993, we have performed preoperative embol ization therapy (PET) in an attempt to augment the blood flow of the gastri c tube and prevent anastomotic leakage after esophageal resection. The clin ical effects and complications associated with PET are reported. Methods: The femoral artery was punctured and the left gastric artery, righ t gastric artery, and splenic artery underwent embolization, leaving the ri ght gastroepiploic artery as the only patent feeding artery for the stomach . PET was performed in 54 patients, and data concerning blood flow of the s tomach before and after the construction of the gastric tube were available in 51 patients. Of the 25 patients who were operated in the same period wi thout undergoing PET, similar data were available in 20 patients. Results: In the group of patients who underwent PET. the blood flow of the gastric tube after its construction was 67% of the value measured at the up per part of the stomach just after opening the abdominal cavity. For those who were not pretreated by PET, it declined to 33%. Conclusions: PET for esophageal cancer is a safe procedure that contributes to the decrease in the frequency of anastomotic dehiscence after esophagea l operation, owing to the augmented tissue blood flow of the upper portion of the stomach following the construction of gastric tubes. (C) 1998 Wiley- Liss, Inc.