Efficacy of gastric blood supply redistribution by transarterial embolization: Preoperative procedure to prevent postoperative anastomotic leaks following esophagoplasty for esophageal carcinoma

Purpose: The aim of this study was to evaluate the effect of preoperative r edistribution of gastric blood supply on the prevention of anastomotic leak age following surgical reconstruction of the esophagus, Methods: In 37 patients with esophageal carcinoma, transarterial embolizati on (TAE) of the left gastric, right gastric, and splenic arteries was preop eratively performed with coils so that gastric blood supply was dependent o nly on the right gastroepiploic artery. Results: In 34 of 37 patients, preoperative redistribution was successfully performed. The gastric tissue blood flow (TBF) of a gastric tube was highe r than in 12 nonredistributed patients. Reduction in the gastric TBF during preparation of a gastric tube was 27.5% in successful patients, in contras t to 68.9% in 12 nonredistributed patients (p < 0.005). Conclusion: Preoperative redistribution by TAE reduced the drop in gastric TBF during preparation of a gastric tube and helped prevent postoperative a nastomotic leakage in esophageal reconstruction.