154. EVALUATION OF BLOOD FLOW IN RECONSTRUCTED GASTRIC TUBE AND IDENTIFICATION OF OPTIMAL ANASTOMOSES IN ESOPHAGECTOMY

Abstract Background Anastomotic leakage in esophageal cancer surgery may be reduced by the evaluated blood flow to the reconstructed organ, but it is difficult to evaluate quantitatively arterial and venous blood flow. This study aimed to evaluate quantitatively blood flow that has not been possible before, and to determine the relationship between the blood flow in the gastric tube with anastomosis leakage using near-infrared spectroscopy. Methods This single-center, observational study included 50 patients aged 51 to 82 who underwent radical esophagectomy with gastric tube reconstruction for esophageal cancer from June 2022 and January 2023. Regional tissue oxygen saturation was measured at the antrum (point X), the anastomotic point (point Z), and the midpoint between points X and Z (point Y) before and after gastric tube formation. These, alongside the decreasing rate of oxygen saturation at the three points, were investigated in relation to anastomosis leakage. Results Regional tissue oxygen saturation at points X and Z after gastric tube formation was significantly lower in the presence of leakage than in its absence. The decreasing rate of regional tissue oxygen saturation at point Z was significantly higher in the presence of leakage than in its absence. There was no significant difference in the decreasing rate of regional tissue oxygen saturation at point X and Y between the presence and absence of leakage. The cut-off decreasing rate of the rSO2 was 29.4%. Conclusion Regional tissue oxygen saturation levels may be useful for measuring blood flow and may be a predictor of anastomosis leakage.