• Rikard Ambrus, Lars B Svendsen, Niels H Secher, Kim Rünitz, Hans-Jørgen Frederiksen, Svendsen Morten B S MB c Copenhagen Academy for Medical Education and Simulation (CAMES) , Rigshospitalet , Copenhagen , Denmark., Mette Siemsen, Steen C Kofoed, and Michael P Achiam.
• a Department of Surgical Gastroenterology , Rigshospitalet , Copenhagen , Denmark.
• Scand. J. Gastroenterol. 2017 Apr 1; 52 (4): 455-461.

BackgroundReduced microvascular blood flow is related to anastomotic insufficiency following esophagectomy, emphasizing a need for intraoperative monitoring of the microcirculation. This study evaluated if laser speckle contrast imaging (LSCI) was able to detect intraoperative changes in gastric microcirculation.MethodsGastric microcirculation was assessed prior to and after reconstruction of gastric continuity in 25 consecutive patients operated for adenocarcinoma with open Ivor-Lewis esophagectomy while hemodynamic variables were recorded.ResultsDuring upper laparotomy, microcirculation at the corpus decreased by 25% from baseline to mobilization of the stomach (p = .008) and decreased further (to a total decrease of 40%) following gastric pull to the thorax (p = .013). On the other hand, microcirculation at the antrum did not change significantly after gastric mobilization (p = .091). The decrease in corpus microcirculation took place unrelated to central cardiovascular variables.ConclusionUsing LSCI technique, we identified a reduced microcirculation at the corpus area during open Ivor-Lewis esophagectomy. LSCI provides an option for real-time assessment of gastric microcirculation and could form basis for intraoperative stabilization of the microcirculation.

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