Pulse Oximetry for Assessment of Gastric Tube Circulation in Esophageal Replacement After Subtotal Esophagectomy

  • J. Salo
  • H. Savolainen
  • L. Heikkilä
Conference paper


Due to its simplicity, the stomach is widely used as a substitute following an esophageal resection, particularly in malignant diseases. In cancer patients, the smaller curvature of the stomach is resected, and the left gastric, gastroepiploic and the short gastric arteries are ligated to enhance surgical radicality and to achieve added length on the esophageal conduit [1]. This technique demands extensive gastric mobilization using the Kocher manoeuver followed by an anastomosis in the neck between the esophageal remnant and the highest point of the gastric fundus. This, however, may compromise the circulation of the anastomotic area of the fundus and results in anastomotic leakage and stricture. Clinically, the fundic circulation may be difficult to assess since the fundus is vascularized only via a nonvisible submucosal plexus [2].


Pulse Oximetry Gastric Tube Pulse Oximeter Esophageal Resection Subtotal Esophagectomy 
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  1. 1.
    Akiyama H, Tsurumaru M, Kawamura T, Oho Y (1981) Principles of surgical treatment for carcinoma of the esophagus. Ann Surg 194: 438–446PubMedCrossRefGoogle Scholar
  2. 2.
    Thomas DM, Langford RM, Russell RCG, Le Quesne (1979) The anatomical basis for gastric mobilization in total oesophagectomy. Br J Surg 66: 230–233PubMedCrossRefGoogle Scholar
  3. 3.
    Yelderman M, New Jr. W (1983) Evaluation of pulse oximetry. Anesthesiology 59: 349–352PubMedCrossRefGoogle Scholar
  4. 4.
    Kidd JF, Vickers MD (1989) Pulse oximeters: Essential monitors with limitations (editorial). Br J Anaesth 62: 355–357PubMedCrossRefGoogle Scholar
  5. 5.
    Ferrara JJ, Dyess DL, Lasecki M, Kinsey S, Donnell C, Jurkovich GJ (1988) Surface oximetry. A new method to evaluate intestinal perfusion. Am Surg 54: 10–14PubMedGoogle Scholar
  6. 6.
    DeNobile J, Guzzetta P, Patterson K (1991) Pulse oximetry as a means of assessing bowel viability. J Surg Res 48: 21–23CrossRefGoogle Scholar
  7. 7.
    Ouriel K, Fiore WM, Geary JE (1988) Detection of occult colonic ischemia during aortic procedures: Use of an intraoperative photoplethysmographic technique. J Vase Surg 7: 5–9Google Scholar
  8. 8.
    Orringer MB (1984) Transhiatal esophagectomy without thoracotomy for carcinoma of the thoracic esophagus. Ann Surg 200: 282–286PubMedCrossRefGoogle Scholar
  9. 9.
    Peracchia A, Bardini R, Ruol A, Asolati M, Scibetta D (1988) Esophagovisceral anastomotic leak. J Thorac Cardiovasc Surg 95: 685–691PubMedGoogle Scholar
  10. 10.
    Liebermann-Meffert D, Raschke M, Siewert JR (1989) How well vascularized is a gastric tube from the greater curvature? Fourth world congress of the International Society for Diseases of the Esophagus. Chicago, Abstract book.Google Scholar

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • J. Salo
  • H. Savolainen
  • L. Heikkilä
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryHelsinki University Central HospitalHelsinkiFinland

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