Vascularization of the gastric stump tubule in esophagogastroplasty (EGP)

The authors present the results of the vascular supply of tubulized gastric stump in patients who had sub-total oesophagectomy and cervical oesophago-gastroplasty (OGP) for oesophageal carcinoma, evaluating the importance of altered tubulized gastric stump's vascular supply on oesophago-gastric anastomosis efficiency. From April 1989 up today 51 patients who had OGP entered this study. Among these 2 had intestinal reconstruction by whole stomach and 49 by tubulized gastric stump. These 49 patients had celiac and upper mesenteric arterial angiography 30 days after surgery. As regards vascular patency angiography allowed us to divide the tubulized gastric stump into three parts; giving useful information above all on the distal part of the stump, considered "at risk" as concerning vascular supply. The authors thus demonstrate that the anastomosis high rate dehiscence is preferably due to the oesophageal stump vascular supply (strongly affected by cervical dissection) rather than to the poor vascular supply of the distal third of the transposed tubulized gastric stump