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This version was published on June 1, 2008
Surgical Innovation, Vol. 15, No. 2, 132-135 (2008)
DOI: 10.1177/1553350608317352

Reviews

Laparoscopic Gastric Ischemic Conditioning Prior to Esophagogastrectomy: Technique and Review

Esteban Varela, MD

Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, esteban.varela{at}utsouthwestern.edu

Kevin M. Reavis, MD

Department of Surgery, University of California Irvine Medical Center, Irvine, California

Marcelo W. Hinojosa, MD

Department of Surgery, University of California Irvine Medical Center, Irvine, California

Ninh Nguyen, MD

Department of Surgery, University of California Irvine Medical Center, Irvine, California

Esophagectomy can be associated with significant peri-operative morbidity such as leaks and strictures. Gastric ischemia as a result of gastric devascularization is one of the several contributing factors that may play a role in development of these complications. In an attempt to improve gastric tissue perfusion, a technique of gastric ischemic conditioning was proposed. For patients with esophageal cancer and at the time of laparoscopic staging, partial gastric devascularization is achieved by division of the left gastric vessels. Esophagectomy is subsequently performed several days after the gastric ischemic conditioning procedure. Our experience showed that preoperative ligation of left gastric vessels prior to esophagogastrectomy is technically feasible and safe and may decrease ischemic complications such as leaks and strictures.

Key Words: laparoscopic • esophagectomy • gastric ischemic conditioning


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