Esophageal reconstruction: posterior mediastinal or retrosternal route

详细信息    查看全文

• 作者：Jingrong Yang ; MM¹ ; Chi Xu ; MD¹ ; Duohuang Lian ; MB ; Shixin Ye ; MM ; Zhiyong Zeng ; MD ; ^{zhiyongzengzyz12@163.com" class="auth_mail" title="E-mail the corresponding author} ; Daoming Liu ; MD ; Congwen Zhuang ; MM
• 关键词：Posterior mediastinal route ; Retrosternal route ; Minimally invasive esophagectomy
• 刊名：Journal of Surgical Research
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：201
• 期：2
• 页码：364-369
• 全文大小：902 K

文摘

Although posterior mediastinal (PM) route and retrosternal (RS) route have been used for reconstruction after minimally invasive esophagectomy (MIE), the optimal route remains controversial. This study reviewed our experiences with McKeown MIEs for esophageal cancer and aimed to investigate which route was better for esophageal reconstruction.

Materials and methods

From December 2011 to December 2013, 103 patients who underwent McKeown MIE and esophageal reconstruction by PM or RS routes were reviewed. The decision regarding which approach was appropriated mainly depended on the first surgeon's preference and experience. Baseline demographics, operative, and postoperative data of the patients were analyzed.

Results

Fifty-six and forty-seven patients receiving PM and RS route reconstruction were reviewed, respectively. Shorter operation time (P = 0.001), less blood loss (P = 0.029), and longer route length (P < 0.001) were observed in PM route compared with RS route. No difference was observed in the resection type, harvested lymph node, intensive care unit and hospital stay, postoperative complications, and in-hospital mortality between the two routes (all P > 0.05).

Conclusions

Both RS route and PM route were safe and effective. PM route was associated with shorter operation time, less blood loss, but longer route length compared with RS route.