3 years ago

Endoscopy after esophagectomy: Safety demonstrated in a porcine model

Endoscopy is useful in assessing conduit ischemia and anastomotic leaks after esophagectomy but poses a theoretical threat of anastomotic disruption. We used a porcine model to evaluate the safety of endoscopy after esophagectomy. Methods We performed esophagectomies in 10 live pigs and performed endoscopy with progressive air insufflation and continuous intraluminal pressure monitoring. We stopped insufflation when the intraluminal pressure reached a plateau. We assessed the integrity of the conduit and anastomosis via endoscopy. We also performed pulse oximetry of the stomach and Doppler velocimetry of the right gastroepiploic artery on 5 live pigs to study the effects of endoscopic gastric insufflation. Results With gentle air insufflation, there was no measurable increase in intraluminal pressure, disruption of the conduit or anastomosis, or significant gastric distension. With progressive insufflation, the intraluminal pressure reached a plateau at a maximum of 8.7 ± 2.1 cm H2O (95% confidence interval, 7.2-10.2). At this plateau, air leaked retrograde via the mouth, which prevented further gastric distension. There were no significant changes in oxyhemoglobin saturation along various regions in the stomach even with maximal insufflation sustained for 10 minutes. There was a momentary reduction in gastroepiploic flow from 12.0 ± 1.0 [95% confidence interval, 10.8-13.2] mL/min/100 g to 9.6 ± 1.5 [95% confidence interval, 7.8-11.4] mL/min/100 g immediately after maximal insufflation, but flow recovered to 11 ± 1.3 [9.6, 12.8] mL/min/100 g after 10 minutes of sustained insufflation. Conclusions Endoscopy after esophagectomy with gentle or maximal air insufflation results in safe endoluminal pressures and minimal disturbance of blood flow and oxygenation.

Publisher URL: www.sciencedirect.com/science

DOI: S0022522317301836

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.