The Effect of the Intraarterial Perfusion of Prostaglandin E₁ on the Microcirculation of the Gastric Tube Made for Esophageal Reconstruction

Satofumi Nakano

Second Department of Surgery, Dokkyo University School of Medicine

One of the causes of anastomotic leakage following esophageal reconstruction is the disturbance of the local blood flow. To elucidate the effect of local perfusion of the reconstructed gastric tube, an experimental study was performed using dogs. The effects of administration of PGE₁ to either the regional artery(the left gastroepiloic artery)or the sysemic vein were investigated. The dogs in which gastric tubes were made were divided into four groups which continuously recieved; (1) no perfusion (group C, control); (2) administration of saline into the left gastroepiploic artery (group S); (3) administration of PGE₁ into the vein (group Pv); and (4) administration of PGE₁ into the left gastroepiploic artery (roup Pa). In each group, the perfusion unit of blood flow (PU), index of O₂ saturation (ISO₂) and pH at the fundus of the gastric tube were monitored sequentially. Histological evaluation of the gastric tube was also performed. The values of PU, ISO₂ and pH in group S showed no significant improvement compared with those in group C. PU, ISO₂ and pH were significantly increased in both Pa and Pv groups compared to those in group C and were also significantly different between group Pa and group Pv. Histological findings of the gastric tube in group Pa at six hours and24 hours showed no interstitial edema or bleeding, which were markedly seen in group C. From this study, it is concluded that the microcirculation of the gastric tube is significantly improved by arterial administration of PGE₁. It is suggestod that intraarterial infusion of PGE₁ is effective for prevention of leakage at the anastomotic site of esophagogastrostomy.

Key words
prostaglandin E₁, reconstructed gastric tube, microcirculation

Reprint requests
Satofumi Nakano Second Department of Surgery, Dokkyo University School of Medicine 880 Kita-kobayashi, Mibu, Shimotsuga, 321-0293 JAPAN

Accepted
July 28, 1999

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