Universität zu Köln

Bludau, M., Hoelscher, A. H., Vallboehmer, D., Metzger, R., Bollschweiler, E. and Schroeder, W. (2013). Vascular endothelial growth factor expression following ischemic conditioning of the gastric conduit. Dis. Esophagus, 26 (8). S. 847 - 853. CARY: OXFORD UNIV PRESS INC. ISSN 1442-2050

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Abstract

The partial devascularization of the stomach, necessary for esophageal reconstruction with a gastric conduit, impairs microcirculation in the anastomotic region of the gastric fundus. Ischemic conditioning of the gastric tube is considered as a possible approach to improve microcirculation in the gastric mucosa. The aim of this study was to investigate whether ischemic conditioning induces neo-angiogenesis in the gastric fundus by expression of vascular endothelial growth factor (VEGF). Twenty patients with an esophageal carcinoma scheduled for esophagectomy and gastric reconstruction were included. To compare VEGF expression before and after ischemic conditioning, preoperative endoscopic biopsies were taken from the gastric fundus. The surgical procedure consisted of two separate steps, the complete gastric mobilization including partial devascularization of the stomach and after a delay of 4-5 days high transthoracic esophagectomy with intrathoracic gastric reconstruction (Ivor-Lewis procedure). The second tissue sample was obtained from the donut of the stapled esophagogastrostomy. For further work-up, preoperative biopsies and the gastric donuts were fixed in liquid nitrogen. Preoperative and intraoperative VEGF expression was measured by quantitative real-time reverse transcription-polymerase chain reaction (VEGFx100/-actin) and results were compared using Wilcoxon test for paired samples. In all 40 specimens, a distinct expression of VEGF could be detected. Comparing the level of VEGF expression of the preoperative biopsies and postoperative tissue sample, no significant difference could be demonstrated following ischemic conditioning. In this model of ischemic conditioning with delayed reconstruction of 4-5 days, no induction of neo-angiogenesis could be demonstrated by measurement of VEGF expression.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bludau, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoelscher, A. H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vallboehmer, D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Metzger, R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bollschweiler, E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, W. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-472648
DOI:	10.1111/j.1442-2050.2012.01391.x
Journal or Publication Title:	Dis. Esophagus
Volume:	26
Number:	8
Page Range:	S. 847 - 853
Date:	2013
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1442-2050
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AUGMENTS LOCALIZED ANGIOGENESIS; RELEVANT ANIMAL-MODEL; TUBE FORMATION; MICROCIRCULATORY CHANGES; FACTOR VEGF; CANCER; RAT; PIG Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47264