Intravenous NTG to Preserve Gastric Microcirculation During Gastric Tube Reconstruction
Study Details
Study Description
Brief Summary
The aim of the present study was to investigate if NTG, administered intravenously during gastric tube reconstruction, could preserve gastric fundus tissue blood flow and oxygenation and reduce the incidence of postoperative leakage.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
| N/A |
Detailed Description
Complications of oesophagectomy and gastric tube reconstruction are leakage and stenosis, which may be due to compromised microvascular blood flow (MBF) in the gastric tissue. We recently demonstrated that peri-operatively decreased MBF could be improved by topical administration of nitro-glycerine NTG). In this present study we investigate the effect of intravenous NTG on gastric microcirculation.
This single centre, prospective, double blinded study randomized thirty-two patients scheduled for esophagectomy into two groups. The intervention group received intravenous NTG during gastric tube reconstruction, as the control group received normal saline.
Baseline values of MBF, microvascular haemoglobin O2 saturation (μHbSO2), and microvascular haemoglobin concentration (μHbcon) were determined at the gastric fundus before and after gastric tube construction and after pulling up the gastric tube to the neck.
Study Design
Outcome Measures
Primary Outcome Measures
- differences in Microvascular bloodflow []
- differences in microvascular hemoglobinsaturation []
Secondary Outcome Measures
- differences in anastomotic leakage []
- differences in anastomotic stenosis []
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Planned esophagectomy with gastric tube reconstruction
-
written informed consent
-
ASA I and II
Exclusion Criteria:
- younger than 18
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Erasmus MC | Rotterdam | Netherlands | 3000ZA |
Sponsors and Collaborators
- Erasmus Medical Center
Investigators
- Study Chair: Diederik Gommers, MD, PhD, Erasmus MC
- Principal Investigator: Marc Buise, MD, Erasmus MC
- Study Director: Jasper van Bommel, MD, PhD, Erasmus MC
- Principal Investigator: Huug Tilanus, MD, PhD, Erasmus MC
- Principal Investigator: Khe Tran, MD, Erasmus MC
Study Documents (Full-Text)
None provided.More Information
Publications
- Buise MP, Ince C, Tilanus HW, Klein J, Gommers D, van Bommel J. The effect of nitroglycerin on microvascular perfusion and oxygenation during gastric tube reconstruction. Anesth Analg. 2005 Apr;100(4):1107-1111. doi: 10.1213/01.ANE.0000147665.60613.CA.
- Jacobi CA, Zieren HU, Zieren J, Müller JM. Is tissue oxygen tension during esophagectomy a predictor of esophagogastric anastomotic healing? J Surg Res. 1998 Feb 1;74(2):161-4.
- Pierie JP, de Graaf PW, van Vroonhoven TJ, Obertop H. Healing of the cervical esophagogastrostomy. J Am Coll Surg. 1999 Apr;188(4):448-54. Review.
- Siegemund M, van Bommel J, Ince C. Assessment of regional tissue oxygenation. Intensive Care Med. 1999 Oct;25(10):1044-60. Review.
- MEC-2004-160