Intra-operative measurement of the tissue blood flow for evaluating blood supply to the gastric tube for esophageal reconstruction

BACKGROUND/AIMS: Anastomotic leakage after esophageal surgery is still the main reason for postoperative morbidity and mortality. We developed a relia ble procedure for evaluating blood supply to the gastric tube after esophag eal reconstruction. METHODOLOGY: After construction of the gastric tube, tissue blood flow was measured intra-operatively at the anastomotic sites using laser Doppler flo wmetry. RESULTS: There was a distinct difference in tissue blood flow at the distal portion of the gastric tube. The tissue blood flow at the sites of attempt ed anastomosis was considerably decreased compared to the value of the gast ric body (control site). CONCLUSIONS: By measuring tissue blood flow at the attempted anastomotic si te intra-operatively using laser Doppler flowmetry, a sufficiently nourishe d gastric tube could be prepared. It was our hypothesis that total eliminat ion of the ischemic portion would make esophagogastric anastomosis safer an d more reliable.