Neovascularization after ischemic conditioning of the stomach and the influence of follow-up neoadjuvant chemotherapy thereon.
Wideochir Inne Tech Maloinwazyjne
; 13(3): 299-305, 2018 Sep.
Article
em En
| MEDLINE
| ID: mdl-30302142
ABSTRACT
INTRODUCTION:
Esophagectomy and reconstruction remain the optimal treatment for patients with resectable esophageal cancer. Neovascularization after ischemic conditioning of the stomach before esophagectomy is a laparoscopic procedure which may potentially reduce gastric conduit ischemia.AIM:
To investigate the influence of ischemic conditioning on neovascularization along the greater curvature of the stomach and to explore the effect of neoadjuvant chemotherapy on neovascularization after ischemic conditioning. MATERIAL ANDMETHODS:
Staging laparoscopy was performed before the main resection procedure; during this procedure ischemic conditioning was performed. Samples taken from the human stomach were divided into 3 groups group A - patients after ischemic conditioning with a delay of 30-45 days after left gastric artery (LGA) ligation (n = 4); group B - patients who were undergoing neoadjuvant chemotherapy with a delay of 90-140 days after left gastric artery ligation (n = 4); and control group C - patients without ischemic conditioning (n = 7).RESULTS:
After ischemic conditioning with a delay of 30-45 days, the count of neovessels along the greater curvature of the stomach increased from 5.4 ±0.7 in the control group to 17.5 ±0.9 in a low-power field of view (LPF) in group A and increased still further on average to 19.8 ±10.4 in group B.CONCLUSIONS:
Left gastric artery ligation only is a sufficient procedure for ischemic conditioning of the stomach. Neovascularization along the greater curvature is a continuous process that depends on delay time. Neoadjuvant therapy has no influence on the effect of neovascularization.
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Base de dados:
MEDLINE
Idioma:
En
Revista:
Wideochir Inne Tech Maloinwazyjne
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
República Tcheca