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Surface Microdialysis Detects Ischemia After Esophageal Resection: An Experimental Animal Study
Institutionen för Klinisk Vetenskap, Lunds Universitet.
Institutionen för Klinisk Vetenskap, Lunds Universitet.
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.ORCID-id: 0000-0002-5325-2688
Umeå universitet, Medicinska fakulteten, Institutionen för kirurgisk och perioperativ vetenskap, Anestesiologi och intensivvård.
2019 (Engelska)Ingår i: Journal of Surgical Research, ISSN 0022-4804, E-ISSN 1095-8673, Vol. 245, s. 537-543Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: After an esophageal resection, continuity is commonly restored by a gastric tube reconstruction and an intrathoracic anastomosis to the remaining proximal esophagus. Ischemia of the anastomotic region is considered to play a pivotal role in anastomotic leakage. Microdialysis (μD) is an excellent method to measure local biochemical substances and parameters in a specific organ or compartment aiming at early detection of ischemia. This animal study evaluates ischemia of the gastric tube reconstruction using a novel method-μD on organ surfaces. This promising method may have the potential to detect an anastomotic leakage before clinical symptoms develop.

METHODS: Anesthetized normoventilated pigs were used. Surface microdialysis (S-μD) catheters and an intraparenchymal oxygen tension catheter were placed on the stomach. A gastric tube was made and the gastroepiploic artery was divided halfway along the greater curvature to produce severe ischemia at the top of the gastric tube. μD data from four locations (gastric tube, ileum and peritoneal cavity) were recorded every 20 min during the experiment. Tissue samples from all catheter sites underwent histopathological analysis. Intraparenchymal oxygen partial pressure, systemic blood tests, and hemodynamic parameters were recorded.

RESULTS: S-μD data showed values indicating severe ischemia at the top of the gastric tube and intermediate ischemia at the level of transection of the gastroepiploic artery. Ischemia was verified by histopathological analysis of tissue samples and intraparenchymal oxygen tension data.

CONCLUSIONS: S-μD can detect and grade severity of local ischemia in real time, in an animal model.

Ort, förlag, år, upplaga, sidor
Elsevier, 2019. Vol. 245, s. 537-543
Nyckelord [en]
Ischemia, Metabolism, Microdialysis
Nationell ämneskategori
Kirurgi Anestesi och intensivvård Gastroenterologi
Identifikatorer
URN: urn:nbn:se:umu:diva-162922DOI: 10.1016/j.jss.2019.07.060PubMedID: 31470334OAI: oai:DiVA.org:umu-162922DiVA, id: diva2:1347722
Tillgänglig från: 2019-09-02 Skapad: 2019-09-02 Senast uppdaterad: 2019-09-03Bibliografiskt granskad

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Johansson, GöranAbrahamsson, Pernilla

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KirurgiAnestesi och intensivvårdGastroenterologi

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