Long beneficial effects after lipo-prostaglandin E1 administration on the ischemic gastric tube in pigs

Abstract

Lipo-prostaglandin E1 (PGE1) is a new preparation of PGE1 in which it is bound to lipids in order to slow PGE1 release and delay its rate of metabolism. We investigated how long the beneficial effects of intravenous administration of lipo-PGE1 on the ischemic gastric tube continue. The gastric tube was constructed using 15 domestic pigs under general anesthesia and saline, unmodified PGE1 and lipo-PGE1 were infused continuously at a rate of 0.05 microg/kg/min for 10 minutes. Tissue blood flow (TBF) was analyzed from before administration to 120 minutes after the end of administration. There were no obvious changes in TBF during the administration of saline. However, TBF during treatment with unmodified PGE1 and lipo-PGE1 was significantly increased to 13.1 +/- 1.3 and 13.5 +/- 1.4 mL/min/100 g, respectively (paired t-test; P < 0.01). Although TBF was significantly decreased to 8.0 +/- 1.0 mL/min/100 g on 10 minutes after the end of unmodified PGE1 administration (paired t-test; P < 0.01), it was maintained over 10 mL/min/100 g until 120 minutes in lipo-PGE1 group. Lipo-PGE1 infusion leads to the objectively measurable improvement and the prolonged action in the blood perfusion of the gastric tube in pigs.

Gastric tube necrosis following minimally invasive oesophagectomy is a learning curve issue

“…In an experimental study in pigs, significant improvement in gastric tube blood flow was found following intravenous administration of unmodified prostaglandin E 1 (PGE1) and lipo-PGE1 (p<0.01). 18 In a study of gastric ischaemic preconditioning, Beck et al showed in animal models that if the short gastric and left gastric vessels were ligated three weeks prior to oesophagectomy, formation of the gastric tube resulted in the gastric blood flow falling to only 60% of the baseline compared with 16% in those who were not preconditioned (p=0.07). 19 Hölscher et al described their study of 83 cases where laparoscopic preconditioning of the stomach was undertaken at an average of 4.3 days prior to the definitive procedure.…”