Dislocation of the gastric conduit reconstructed via the posterior mediastinal route is a significant risk factor for anastomotic disorder after McKeown esophagectomy

Nakajima, Masahiro; Muroi, Hiroto; Kikuchi, Maiko; Fujita, Junki; Ihara, Kensuke; Nakagawa, Masatoshi; Morita, Shinji; Nakamura, Takatoshi; Yamaguchi, Satoru; Kojima, Kazuyuki

doi:10.1002/ags3.12496

Cited by 1 publication

(1 citation statement)

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“…After esophagectomy, a gastric conduit formed by resection of the lesser curvature is the first choice of an esophageal substitute for reconstruction [ 4 , 5 ]. In the McKeown procedure, esophageal reconstruction with the gastric conduit is usually performed via the posterior mediastinal route, which is considered the most physiological option [ 6 ]. Despite its advantages, this technique has some disadvantages.…”

Section: Introductionmentioning

confidence: 99%

A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy

Yan,

Xu,

Guo

et al. 2024

J Cardiothorac Surg

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Background The gastric conduit is the most commonly used replacement organ for reconstruction after minimally invasive McKeown esophagectomy. Although the optimal route of gastric conduit remains controversial, the posterior mediastinal route is physiologically preferable but is not without disadvantages. Here, we report the safety and efficacy of a method of gastric conduit reconstruction via the anterior of the pulmonary hilum route. Methods We have used the anterior of the pulmonary hilum route since 2021. This procedure involves pulling the gastric conduit up through a substernal tunnel between the right thoracic cavity and the abdominal cavity and passing it into the neck via the anterior of the pulmonary hilum route. In this retrospective study, we compared the clinical outcomes between 20 patients who underwent this procedure and 20 patients who underwent the posterior mediastinal route from 2021 to 2022. Results No mortality was reported in either group. No significant differences were observed between the two groups in duration of surgery, blood loss, incidence of postoperative complications, and postoperative hospital stay. As a result of the anterior of the pulmonary hilum route, the primary tumor bed and lymph node drainage area were effectively bypassed, which facilitates postoperative adjuvant radiotherapy or chemoradiotherapy. The distance of the gastric conduit accompanying the airway was significantly shorter in the anterior of the pulmonary hilum route group. Conclusions Our method is considered to be a safe and useful technique for the reconstruction of gastric conduit.

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Section: Introductionmentioning

confidence: 99%