Reliable anastomosis of esophageal reconstruction using laser Doppler flowmetry

• Project/Area Number: 15591443
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Digestive surgery
• Research Institution: Teikyo University
• Principal Investigator: IKEDA Yoshifumi Teikyo University, School of medicine, Assistant Professor, 医学部, 講師 (20222870)
• Co-Investigator(Kenkyū-buntansha): NIIMI Masanori Teikyo University, School of medicine, Associate Professor, 医学部, 助教授 (80198415) ; 小平 進 帝京大学, 医学部, 教授 (00110015)
• Project Period (FY): 2003 – 2004
• Project Status: Completed (Fiscal Year 2004)
• Budget Amount: ¥3,200,000 (Direct Cost: ¥3,200,000); Fiscal Year 2004: ¥1,500,000 (Direct Cost: ¥1,500,000); Fiscal Year 2003: ¥1,700,000 (Direct Cost: ¥1,700,000)
• Keywords: Tissue Blood Flow / Gastric tube / Lipo-PGE1 / laser Doppler flowmetry / 組織血流測定 / Laser-Dopper flowmetry法

Research Abstract

Introduction : Lrpo-prostaglandin El (PGEI) is a new preparation of PGE1 in which it is bound to lipids in order to slow PGE1 release and delay its rate of metabolism. We investigated the change of the blood flow on impaired microcirculation of the ischemic gastric tube in pigs after saline, unmodified PGE1 and lipo-PGE1 administration.
Materials and Methods : The gastric tube was constructed using fifteen domestic pigs under general anesthesia, and saline, PGE1 and lipo-PGE1 were infused continuously at a rate of 0.05 μg/kg/min for 10 minutes. Tissue blood flow (TBF) and the serum PGE1 concentration were analyzed before administration, after administration for 10 minutes, and 10 minutes after the end of administration.
Results : There were no obvious changes in TBF during the administration of saline. However, TBF during treatment with unmodified PGE1 and lipo-PGE1 was significantly increased to 13.0 ± 1.3 and 13.9 ± 1.3 ml/ min/ 100g, respectively (paired t-test ; p<0.01). Although TBF was significantly decreased to 8.0 ± 1.0 ml/ min/ 100g on 10 minutes after the end of unmodified PGE1 administration (paired t-test ; p<0.01), it was maintained over 10 ml/min/100g in lipo-PGE1 group. The serum PGE1 concentration during treatment with unmodified PGEI and lipo-PGE1 was significantly increased to 229 ± 21 and 225 ± 9 pg/ml (paired t-test ; p<0.01), however, it was significantly decreased to 59 ± 5 and 131 ± 17 pg/ml (paired t-test ; p<0.01), respectively, on 10 minutes after the end of administration. However, the serum PGE1 concentration in lipo-PGE1 group was significantly higher than that in with unmodified PGE1 group (unpaired t-test ; p<0.01).
Conclusion : Lipo-PGE1 infusion leads to the objectively measurable improvement and the prolonged action in the macro-and microcirculation of the gastric tube in pigs. Therefore, treatment with lipo-PGE1 infusion can increase TBF at the anastomotic site, and it may be beneficial for preventing anastomotic leakage in boluses for a couple of times a day.