Evaluation of tissue blood flow of the gastric tube after vessel anastomosis for esophageal reconstruction.

OBJECTIVES AND METHODS Impaired blood flow of the upper end of the gastric tube is one of the major causes of anastomotic leak following esophageal reconstruction after esophagectomy for cancer. We applied an additional microvascular anastomosis procedure--the supercharging technique--to improve blood flow. We investigated blood flow improvement in 15 patients who underwent the supercharging technique after total excision of the thoracic esophagus and gastric tube reconstruction through the posterior mediastinal route from August 2003 to March 2005. RESULTS Tissue blood flow was measured with laser Doppler flowmetry during surgery and was improved after microvascular anastomosis. Patency and blood flow of anastomosed arteries were evaluated with computed tomography and ultrasonography, respectively. Patency and stable blood flow of anastomosed arteries were confirmed more than 1 month after surgery. Therefore, microvascular anastomosis improved the tissue blood flow of the upper end of the gastric tube. Long-term blood flow improvement was confirmed, which suggests that microvascular anastomosis contributes to reducing the risk of anastomotic leak.