Reconstrucción esofágica en un segundo tiempo: coloplastia y gastroplastia

Farran-Teixidó, Leandre; Miró-Martín, Mònica; Biondo, Sebastiano; Conde-Mouriño, Raquel; Bettonica-Larrañaga, C.; Danso, Humberto Aranda; Sans-Segarra, Manel; Rafecas-Renau, Antonio

doi:10.1016/s0009-739x(08)70561-x

Cited by 5 publications

(1 citation statement)

References 14 publications

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“…Different segments of the colon can be used to create the conduit, and a recent meta-analysis [5] stated that left coloplasty was the most frequent (70.9%) procedure, with a small difference in morbidity between left and right coloplasty (15.7% vs. 18.7%, respectively). In our team, we have more experience with right coloplasty [6, 7] which has the following advantages over left coloplasty: less disparity in the caliber between the ileum and esophagus, the possibility that the Bauhin valve acts as an anti-reflux mechanism, and the least variability in terms of vascularization. Arterial vascularization of the right colon is mainly determined by the ileocolic artery and the right branch of the middle colic artery, both communicated through the marginal artery (present in 99.8%, 95%, and 100% of cases, respectively), whereas the right colic artery has a less relevant role, a more variable origin, and is present as such in two-thirds of the cases [8].…”

Section: Introductionmentioning

confidence: 99%

Ischemic Conditioning in the Right Colon and Terminal Ileum: An Experimental Rat Model

et al. 2021

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Introduction: Preoperative gastric ischemic conditioning (IC) improves the outcome of esophageal replacement gastroplasty and is associated with low morbidity. However, when the stomach cannot be used for esophageal replacement, a colonic replacement is required. The study aim was to assess the viability of right colon and terminal ileum IC in a rat model, the histological damage/recovery sequence, and determine if neovascularization is a potential adaptive mechanism. Methods: The study was conducted in Rattus norvegicus with ileocolic vascular ligation. Seven groups of animals were established (six rats per group) with groups defined by the date of their post-IC euthanasia (+1, +3, +6, +10, +15, and +21 days). Comparisons were made with a sham group. Viability of the model was defined as <10% of transmural necrosis. The evaluation of histological damage used the Chiu score in hematoxylin and eosin sections of paraffin-embedded specimens with CD31 immunohistochemical assessment of neovascularization by the median of submucosal vessel counts in five high-magnification fields. Results: Transmural colon necrosis occurred in 1/36 animals (2.78%) with no animal demonstrating transmural ileal necrosis. The maximum damage was observed in the colon on +1 day post-IC (average Chiu score 1.67, P = 0.015), whereas in the ileum, it was on days +1, +3, and +6 (average Chiu score 1.5, 1.3, and 1.17; P = 0.015, 0.002, and 0.015, respectively). In the +21-day group, histological recovery was complete in the colon in four (66.7%) of the six animals and in the ileum in five (83.3%) of six animals. There were no significant differences in quantitative neovascularization in any of the groups when compared with the sham group or when comparisons were made between groups. Conclusions: The tested animal model for IC of the colon and terminal ileum appeared to be feasible. Histological damage was maximal between the 1st and 3rd day following IC, but by day 21, recovery was complete in two-thirds of the rats. There was no evidence in this preliminary IC model that would suggest neovascularization as an adaptive mechanism.

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