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Ann Thorac Surg. 2016 Apr;101(4):1614-23. doi: 10.1016/j.athoracsur.2015.10.034. Epub 2016 Feb 5.

Ischemic Conditioning of the Stomach in the Prevention of Esophagogastric Anastomotic Leakage After Esophagectomy.

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Department of Surgery, University Medical Centre Utrecht, Utrecht, Netherlands; Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland. Electronic address:
Department of Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.


Esophagectomy with esophagogastric anastomosis is a major procedure, and its most feared complication is anastomotic leakage. Ischemic conditioning of the stomach is a method used with the aim of reducing the risk of leakage. It consists of partial gastric devascularization through embolization or laparoscopy followed by esophagectomy and anastomosis at a second stage, thus providing the time for the gastric conduit to adapt to the acute ischemia at the time of its formation. This review analyzes the information from all currently available experimental and clinical studies with the purpose of assessing the current role of the technique and to provide future recommendations.

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