A reduced gastric corpus microvascular blood flow during Ivor-Lewis esophagectomy detected by laser speckle contrast imaging technique

Scand J Gastroenterol. 2017 Apr;52(4):455-461. doi: 10.1080/00365521.2016.1265664. Epub 2016 Dec 15.


Background: Reduced microvascular blood flow is related to anastomotic insufficiency following esophagectomy, emphasizing a need for intraoperative monitoring of the microcirculation. This study evaluated if laser speckle contrast imaging (LSCI) was able to detect intraoperative changes in gastric microcirculation.

Methods: Gastric microcirculation was assessed prior to and after reconstruction of gastric continuity in 25 consecutive patients operated for adenocarcinoma with open Ivor-Lewis esophagectomy while hemodynamic variables were recorded.

Results: During upper laparotomy, microcirculation at the corpus decreased by 25% from baseline to mobilization of the stomach (p = .008) and decreased further (to a total decrease of 40%) following gastric pull to the thorax (p = .013). On the other hand, microcirculation at the antrum did not change significantly after gastric mobilization (p = .091). The decrease in corpus microcirculation took place unrelated to central cardiovascular variables.

Conclusion: Using LSCI technique, we identified a reduced microcirculation at the corpus area during open Ivor-Lewis esophagectomy. LSCI provides an option for real-time assessment of gastric microcirculation and could form basis for intraoperative stabilization of the microcirculation.

Keywords: Gastric microcirculation; Ivor-Lewis esophagectomy; intraoperative monitoring; laser speckle contrast imaging.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Anastomosis, Surgical / adverse effects
  • Contrast Media / pharmacology
  • Denmark
  • Esophagectomy / adverse effects*
  • Female
  • Hemodynamics
  • Humans
  • Laparoscopy / adverse effects
  • Male
  • Microcirculation*
  • Microscopy, Confocal
  • Microscopy, Video
  • Middle Aged
  • Monitoring, Intraoperative / methods*
  • Prospective Studies
  • Regional Blood Flow
  • Regression Analysis
  • Stomach / blood supply
  • Stomach / diagnostic imaging*
  • Stomach / surgery


  • Contrast Media