V. Di Benedetto et A. Dessanti, Experimental technique of esophageal substitution: Intrathoracic interposition of a pedunculated gastric tube (PGT) preserving cardiac function. Preliminary results, HEP-GASTRO, 45(24), 1998, pp. 2202-2205
BACKGROUND/AIMS: The authors present an experimental technique performed on
piglets to replace a segment of the thoracic esophagus with a gastric tube
pedunculated on gastroepiploic vessels transposed between proximal and dis
tal esophageal segments, and consequently preserve cardiac function.
METHODOLOGY: Four piglets aged between 30 and 75 days, weight 6-20kg, under
went esophageal replacement with a gastric tube, length 6-10cm (mean: 8cm),
constructed from the greater gastric curvature and pedunculated on the gas
troepiploic vessels. The gastric tube thus obtained, it was transposed into
the right hemithorax through a small opening in the diaphragm. Esophageal
reconstruction was done by interposition of the gastric tube between the up
per and lower esophageal stumps.
RESULTS: The post-operative course was uneventful. An esophagogram on the 4
th post-operative day showed no anastomotic leakage in all cases, and oral
food intake could be commenced. At follow-up, the animals were found to be
eating normally.
CONCLUSIONS: This experimental technique could have important advantages ov
er existing techniques of esophageal replacement:
1) cardiac function is preserved;
2) it is technically easy to obtain a gastric tube with a long vascular ped
icle, so replacement up to the superior esophagus is possible; and,
3) in the post-operative period, no swallowing difficulties appear to occur
.