PS02.076: VISUALIZATION OF BLOOD SUPPLY ROUTE TO THE RECONSTRUCTED STOMACH BY INDOCYANINE GREEN FLUORESCENCE IMAGING DURING ESOPHAGECTOMY, 2ND REPORT

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 141-142
Author(s):  
Yasushi Rino ◽  
Takashi Oshima ◽  
Tsutomu Sato ◽  
Toru Aoyama ◽  
Norio Yukawa ◽  
...  
Keyword(s):  
Blood Flow ◽  
Esophageal Cancer ◽  
Blood Vessels ◽  
Fluorescence Imaging ◽  
Blood Supply ◽  
Gastric Wall ◽  
Gastroepiploic Artery ◽  
Greater Omentum ◽  
Splenic Hilum ◽  
Greater Curvature

Abstract Background Recently, indocyanine green (ICG) fluorescence imaging has been used to visualize the blood supply when anastomosis is performed in vascular surgery. We have reported the three blood supply routes to the reconstructed stomach using ICG fluorescence imaging for reconstruction during esophagectomy. Blood flow routes in the 33 patients with esophageal cancer were classified into categories on the basis of ICG imaging findings: the gastric wall route, the greater curvature route, and the omentum and splenic hiatal route. The gastric wall route was found in 13 patients and characterized by large blood vessels in the gastric wall. The greater curvature route was present in 11 patients and characterized by blood vessels in the greater omentum. The omentum and beside splenic hilum route was found in 22 patients. Blood vessels ran in the greater omentum beside the splenic hilum. a photodynamic eye (PDE) showed blood flow from right gastroepiploic artery, omentum vessels, left gastroepiploic artery, splenic hiatal vessels, short gastric artery, and gastric wall vessels to the top of the reconstructed stomach. The ‘splenic hiatal route’ was present in 66.7% of the patients and was formed by large vessels or networks of small vessels. We rechecked the ‘splenic hiatal route’ cases and recognize that the branch parted from the right gastroepiploic artery. We tried preservation of the ‘splenic hiatal route’. Methods Since January 2017, we have preserved the ‘splenic hiatal route’ and performed ICG fluorescence imaging in 5 patients with thoracic esophageal cancer who underwent thoracic esophagectomy. After pulling up the reconstructed stomach, 2.5 mg of ICG was injected as a bolus. ICG fluorescence imaging was performed with a near-infrared camera, and the images were recorded. Results ICG fluorescence was easily detected in all patients 1 min after injection. Vascular networks were well visualized in the gastric wall and omentum. The blood supply route was visualized the ‘splenic hiatal route’ in all patients. Conclusion On ICG fluorescence imaging, the splenic hiatal vessels would be the major blood supply for the anastomosis in most patients. Disclosure All authors have declared no conflicts of interest.

Innervation of endoneurial microvessels in human sural nerve

1992 ◽  
Vol 50 (1) ◽  
pp. 920-921
Author(s):  
John L. Beggs ◽  
Peter C. Johnson ◽  
Astrid G. Olafsen ◽  
C. Jane Watkins
Keyword(s):  
Blood Flow ◽  
Blood Vessels ◽  
Blood Supply ◽  
Peripheral Nerves ◽  
Sural Nerve ◽  
Nerve Fibers ◽  
Arterial Supply ◽  
Autonomic Nerve ◽  
Vasa Nervorum ◽  
Endoneurial Blood Flow

The blood supply (vasa nervorum) to peripheral nerves is composed of an interconnected dual circulation. The endoneurium of nerve fascicles is maintained by the intrinsic circulation which is composed of microvessels primarily of capillary caliber. Transperineurial arterioles link the intrinsic circulation with the extrinsic arterial supply located in the epineurium. Blood flow in the vasa nervorum is neurogenically influenced (1,2). Although a recent hypothesis proposes that endoneurial blood flow is controlled by the action of autonomic nerve fibers associated with epineurial arterioles (2), our recent studies (3) show that in addition to epineurial arterioles other segments of the vasa nervorum are also innervated. In this study, we examine blood vessels of the endoneurium for possible innervation.

scholarly journals Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yasunori Kurahashi ◽  
Yudai Hojo ◽  
Tatsuro Nakamura ◽  
Tsutomu Kumamoto ◽  
Yoshinori Ishida ◽  
...  
Keyword(s):  
Blood Flow ◽  
Esophageal Cancer ◽  
Anastomotic Leakage ◽  
Gastric Wall ◽  
Sternoclavicular Joint ◽  
Gastric Conduit ◽  
Thoracic Inlet ◽  
Indocyanine Green Fluorescence ◽  
Subtotal Esophagectomy ◽  
First Case

Abstract Background The narrowness of the thoracic inlet is often a problem in retrosternal reconstruction after esophagectomy. We report here three cases in which compression of the gastric conduit behind the sternoclavicular joint possibly caused anastomotic leakage. Case presentations The first case was a 71-year-old man who underwent subtotal esophagectomy for upper esophageal cancer followed by retrosternal reconstruction. On postoperative day 2, he developed septic shock and underwent reoperation because of a necrotic gastric conduit. The tip of the conduit above the manubrium was necrotic due to strangulation as a result of compression by the sternoclavicular joint. The second and third cases were a 50-year-old woman and a 71-year-old man who underwent subtotal esophagectomy for middle and lower esophageal cancer, respectively, followed by retrosternal reconstruction. Despite indocyanine green fluorescence imaging indicating adequate blood flow in both cases, the tip of the conduit appeared pale and congested because of compression by the sternoclavicular joint after anastomosis. Postoperatively, these two patients developed anastomotic leakage that was confirmed endoscopically on the ventral side of the gastric wall that had been pale intraoperatively. Conclusions When performing reconstruction using the retrosternal route after esophagectomy, it is important to ensure that compression by the sternoclavicular joint does not have an adverse impact on blood flow at the tip of the gastric conduit.

649 EFFECTS OF THE PREPARATION METHOD ON THE ICG FLUORESCENCE BLOOD FLOW IN THE GASTRIC CONDUIT AFTER ESOPHAGECTOMY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Kazuo Koyanagi ◽  
Soji Ozawa ◽  
Yamato Ninomiya ◽  
Kentaro Yatabe ◽  
Tadashi Higuchi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Esophageal Cancer ◽  
Fluorescence Imaging ◽  
Conventional Method ◽  
Current Method ◽  
Flow Speed ◽  
Gastric Conduit ◽  
Gastric Artery ◽  
Conduit Wall ◽  
Lesser Curvature

Abstract   In this study, we investigated how the blood flow of gastric conduit changed due to the difference in the lesser curvature cut line using ICG fluorescence imaging in patients with esophageal cancer. Methods A total of 193 cases of esophageal cancer surgery with gastric conduit reconstruction were included. (Conventional method) The lesser curvature cut line of the stomach was started from a distance of 5 cm from the pylorus (141 cases). (Current method) Gastric lesser curvature dissection was started from the last branch of the left gastric artery (52 cases). Blood flow of the gastric conduit was measured by the ICG fluorescence imaging, and the correlation between the changes in the gastric conduit and both blood flow and anastomotic failure was examined. Results Median length of the lesser curvature cut line was 10 cm from the pylorus in the current method, which was significantly longer than that in the conventional method (P < 0.001). Congestion at the tip of the gastric conduit were more observed in the conventional method (P = 0.02). The ICG fluorescent blood flow speed in the gastric conduit wall was 2.54 cm/s by the conventional method and 2.82 cm/s by the current method (P = 0.03). There were 23 cases (16.3%) of anastomotic leakage in the conventional method and 4 cases (7.7%) in the current method (P = 0.09). Conclusion By preserving the right gastric artery and vein, improvement of venous return is expected, and it is suggested that blood flow in the gastric conduit wall can be well maintained.

scholarly journals VASCULAR ANATOMY OF GREATER OMENTUM IN MIDDLE AGE ADULTS

2021 ◽  
Vol 21 (2) ◽  
pp. 169-175
Author(s):  
I.L. Fedorchenko
Keyword(s):  
Blood Supply ◽  
Middle Age ◽  
Gastroepiploic Artery ◽  
Greater Omentum ◽  
Outer Diameter ◽  
Lower Edge ◽  
Right Gastroepiploic Artery ◽  
Free Part ◽  
Central Artery ◽  
The Right

The variability of artery and vein topography of greater omenta from 20 corpses of middle age adults was investigated by applying the anatomical and morphometric methods. The right and left gastroepiploic arteries supply the greater omentum with blood. In 80% of the cases studied these arteries form the superior arterial arch, in 15% of the cases they are not connected, and in 5% of the cases they form anastomosis through the right and left lateral branches, thus, forming the middle arterial arch of the greater omentum. In 10% of the cases, the left gastroepiploic artery is located in the thick of the posterior plate of the greater omentum. The right gastroepiploic artery branches into central, right medial, intermediate and lateral arteries and in 10% left additional artery. The right gastroepiploic artery and vein are longer in men (16.95 ± 5.5 cm) that in women (15.77 ± 2.9 cm). The outer diameter of these vessels is larger in women: 0.24 ± 0.03 cm of arteries and 0.27 ± 0.03 cm of veins. The central artery is the longest and widest of all omental branches. The area of the central artery is more preferred for flaps in quadrangular and triangular shapes of the greater omentum. The branches of the right gastroepiploic artery supply blood to the right half of the greater omentum and reach the lower edge of its free part. The left half of the greater omentum is supplied by the branches of the left gastroepiploic artery, namely by the left medial, intermediate and lateral arteries, which do not reach the lower edge of the free part of the omentum. In 10% of the cases, the superior left part of the omentum is additionally supplied with blood by the splenic artery. On such case of blood vessels presence, it can serve as a source for obtaining a flap. One vein accompanies the artery of the same name. All the veins of the omentum have a larger diameter than the arteries. In 15% of the cases greater omentum is quadrangular, in 25% of the cases is triangular and in 60% it is of irregular shape with two or more parts. In the one-part omentum, the left and right parts have the same blood supply. At the two-part structure, the right half is in more favourable condition in terms of the blood supply that enables to recommend its usage in transplantation surgery.

scholarly journals Development of blood vessels of the greater omentum in the hepatic lobe after vascular ligation: an experimental model in the rats

2006 ◽  
Vol 21 (6) ◽  
pp. 416-421 ◽  
Author(s):  
Paulo Cesar Silva ◽  
Nelson Jamel ◽  
Ricardo Antonio Refinetti ◽  
Eduardo Ferreira Manso ◽  
Alberto Schanaider
Keyword(s):  
Blood Flow ◽  
Blood Vessels ◽  
Wistar Rats ◽  
Histopathological Examination ◽  
Greater Omentum ◽  
Hepatic Lobe ◽  
Vascular Lumen ◽  
Vascular Ligation ◽  
Male Wistar Rats ◽  
The Right

PURPOSE: To verify the development of blood vessels between the greater omentum and the liver in the presence of distinct liver blood intake blockages. METHODS: Two hundred and eighty conventional male Wistar rats were used, divided into 5 groups: control (n=35), laparotomy (n=35); hepatic artery ligature (n=70), ligature of the right-hand branch of the portal vein (n=70); and ligature of both blood vessels (n=70). The last three groups were divided into two subgroups each (n=35), according to the presence or absence of the transposition of the greater omentum onto the right hepatic lobe. The postoperative periods were 1, 3, 7, 15, 30, 60 and 90 days. At the end of each period, the greater omentum and right hepatic lobe were collected for histopathological examination. The presence of blood vessels between the referred tissues was verified by the administration of Indian ink as a marker of vascular lumen. RESULTS: Macroscopic and microscopic observation and the dye marker demonstrated the distribution of blood vessels between the greater omentum and liver tissues. CONCLUSION: The greater omentum was capable of developing blood vessels when fixed to the parenchyma of the liver after the suppression of hepatic blood flow.

COMPARISON OF ANTIHYPERTENSIVE EFFECT OF MOXONIDINE VERSUS CLONIDINE IN RENAL FAILURE PATIENTS.

2018 ◽  
Vol 6 (9) ◽  
Author(s):  
DR.MATHEW GEORGE ◽  
DR.LINCY JOSEPH ◽  
MRS.DEEPTHI MATHEW ◽  
ALISHA MARIA SHAJI ◽  
BIJI JOSEPH ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Failure ◽  
Blood Flow ◽  
Blood Vessel ◽  
Blood Vessels ◽  
High Blood Pressure ◽  
Antihypertensive Effect ◽  
The Body ◽  
Ability To Work ◽  
Blood Flows

Blood pressure is the force of blood pushing against blood vessel walls as the heart pumps out blood, and high blood pressure, also called hypertension, is an increase in the amount of force that blood places on blood vessels as it moves through the body. Factors that can increase this force include higher blood volume due to extra fluid in the blood and blood vessels that are narrow, stiff, or clogged(1). High blood pressure can damage blood vessels in the kidneys, reducing their ability to work properly. When the force of blood flow is high, blood vessels stretch so blood flows more easily. Eventually, this stretching scars and weakens blood vessels throughout the body, including those in the kidneys.

Sign in / Sign up

Export Citation Format

Share Document