Microcirculatory perfusion of the canine esophagus before and after blind longitudinal dissection and thoracoscopic distal transsection

In the treatment of distal esophageal pathology, surgical mobilization and exteriorization of the thoracic esophagus can be necessary. This may threat en its vascularization. We investigated the effect of longitudinal dissecti on and distal transsection on the microcirculatory perfusion of the canine esophagus. Esophageal perfusion and muscular oxygenation were investigated in 11 dogs using laser Doppler fluxmetry and oxygen pressure measurements b efore and up to 2 weeks after longitudinal dissection with and without dist al thoracoscopic transsection. Histological examination was performed at th e end of the follow-up period. Distal esophageal perfusion was higher than proximal. Longitudinal dissection caused an insignificant reduction, wherea s additional transsection significantly lowered esophageal perfusion, which was restored only partially during follow-up. After transsection distal mu scular oxygen pressure was also significantly lower than proximal. Histolog ically, no significant ischemic cell damage was observed. Laser Doppler per fusion measurement is a feasible technique to measure (changes in) microcir culatory circulation of the esophageal wall. This may be useful in clinical settings to monitor the viability of the esophagus after surgical interven tions. Distal transsection substantially reduces esophageal perfusion witho ut apparent short-term histological damage. (C) 1999 Academic Press.