Relationship of venous blood gas with cervical esophagogastric anastomotic leak

Asian Cardiovasc Thorac Ann. 2012 Oct;20(5):566-9. doi: 10.1177/0218492312450519.

Abstract

Objective: this study investigated the relationship between various parameters of venous blood gas analysis of gastric fundus veins and cervical esophagogastric anastomotic leaks after transhiatal esophagectomy.

Background: decreased tissue perfusion is one of the causes of anastomotic leak. There are various methods used to assess gastric conduit perfusion, with different results, and we lack a reliable method.

Method: this descriptive study, performed from March 2008 to October 2010, consisted of 45 patients with esophageal cancer who underwent transhiatal esophagectomy. After gastrolysis, blood samples were taken from a gastric fundus vein and submitted for venous blood gas analysis. The cervical wounds were examined 5 days postoperatively. The patients were divided into 2 groups based on the presence of leakage, and mean values of the venous blood gas analysis were compared.

Results: we observed significant differences in mean pH, PCO(2), and O(2) saturation between the 2 groups (p = 0.04, p = 0.03, and p = 0.04, respectively).

Conclusion: venous blood gas analysis of gastric fundus veins appears to be a feasible and fast method for intraoperative assessment of microperfusion in the gastric fundus.

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Anastomotic Leak / blood
  • Anastomotic Leak / etiology*
  • Anastomotic Leak / physiopathology
  • Biomarkers / blood
  • Blood Gas Analysis*
  • Carbon Dioxide / blood*
  • Esophageal Neoplasms / surgery*
  • Esophagectomy*
  • Female
  • Gastric Fundus / blood supply*
  • Gastric Fundus / surgery*
  • Humans
  • Hydrogen-Ion Concentration
  • Male
  • Microcirculation
  • Middle Aged
  • Oxygen / blood*
  • Predictive Value of Tests
  • Prospective Studies
  • Regional Blood Flow
  • Splanchnic Circulation
  • Time Factors
  • Treatment Outcome
  • Veins

Substances

  • Biomarkers
  • Carbon Dioxide
  • Oxygen