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Thorac Cardiovasc Surg 2021; 69(03): 211-215
DOI: 10.1055/s-0040-1709138
Original Thoracic

The Complications between Different Routes of Reconstruction after Esophagectomy

Mingdong Wang
1   Department of Thoracic Surgery, Changzheng Hospital, Shanghai, People's Republic of China
,
Yuxiang Jin
1   Department of Thoracic Surgery, Changzheng Hospital, Shanghai, People's Republic of China
,
Guangyuan Sun
1   Department of Thoracic Surgery, Changzheng Hospital, Shanghai, People's Republic of China
,
Xuewei Zhao
1   Department of Thoracic Surgery, Changzheng Hospital, Shanghai, People's Republic of China
,
Lei Xue
1   Department of Thoracic Surgery, Changzheng Hospital, Shanghai, People's Republic of China
› Author AffiliationsSupported by: Nature Science Foundation of Shanghai 16ZR1436900
Supported by: Shanghai Education Development Foundation and Shanghai Municipal Education Commission 16SG32
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Abstract

Background The main purpose of this study was to compare the postoperative complications caused by surgical reconstruction via either retrosternal (RS) or prevertebral (PV) routes in thoracoscopic and laparoscopic esophagectomy patients.

Materials and Methods We retrospectively screened the perioperative data in total 59 patients who underwent minimally invasive esophagectomy in time period from January 2016 to January 2018. All the patients were subgrouped into two cohorts according to the surgical routes being taken: the RS route group (28 patients) and the PV route group (31 patients). The perioperative data including operation and hospitalization time and surgical complications were comparatively analyzed.

Results The surgical procedure in all patients was successful and no case of death occurred during perioperative stage in both groups. Notably, patients in the RS group had significantly lower propensity of pneumonia than patients in the PV group (p < 0.05). However, comparative analysis revealed almost an identical time for both operative process and postoperative hospitalization. And there was no statistical significance in the rate of anastomotic leakage and stricture as well as other complications (p > 0.05).

Conclusion RS and PV paths are both safe and effective routes that yielded similar postoperative complications. Reconstruction after thoracoscopic and laparoscopic esophagectomy via the RS route had lower propensity of pneumonia than PV route.

Keywords

esophageal cancer - minimally invasive esophagectomy - retrosternal path - prevertebral path - postoperative complications


Publication History

Received: 27 November 2019

Accepted: 24 February 2020

Article published online:
25 July 2020

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • Reference

  • 1 Sohda M, Kuwano H. Current status and future prospects for esophageal cancer treatment. Ann Thorac Cardiovasc Surg 2017; 23 (01) 1-11
    CrossrefPubMedGoogle Scholar
  • 2 Wang H, Tan L, Feng M, Zhang Y, Wang Q. Comparison of the short-term health-related quality of life in patients with esophageal cancer with different routes of gastric tube reconstruction after minimally invasive esophagectomy. Qual Life Res 2011; 20 (02) 179-189
    CrossrefPubMedGoogle Scholar
  • 3 Moon DH, Lee JM, Jeon JH, Yang HC, Kim MS. Clinical outcomes of video-assisted thoracoscopic surgery esophagectomy for esophageal cancer: a propensity score-matched analysis. J Thorac Dis 2017; 9 (09) 3005-3012
    CrossrefPubMedGoogle Scholar
  • 4 Caronia FP, Arrigo E, Failla AV. et al. Uniportal thoracoscopy combined with laparoscopy as minimally invasive treatment of esophageal cancer. J Thorac Dis 2018; 10 (04) E265-E269
    CrossrefPubMedGoogle Scholar
  • 5 Li B, Yang Y, Sun Y. et al. Minimally invasive esophagectomy for esophageal squamous cell carcinoma-Shanghai Chest Hospital experience. J Thorac Dis 2018; 10 (06) 3800-3807
    CrossrefPubMedGoogle Scholar
  • 6 Ma G, Cao H, Wei R. et al. Comparison of the short-term clinical outcome between open and minimally invasive esophagectomy by comprehensive complication index. J Cancer Res Ther 2018; 14 (04) 789-794
    CrossrefPubMedGoogle Scholar
  • 7 Ma S, Yan T, Liu D. et al. Minimally invasive esophagectomy in the lateral-prone position: experience of 124 cases in a single center. Thorac Cancer 2018; 9 (01) 37-43
    CrossrefPubMedGoogle Scholar
  • 8 Huang Q, Zhong J, Yang T. et al. Impacts of anastomotic complications on the health-related quality of life after esophagectomy. J Surg Oncol 2015; 111 (04) 365-370
    CrossrefPubMedGoogle Scholar
  • 9 Tachimori Y, Ozawa S, Numasaki H. et al; Registration Committee for Esophageal Cancer of the Japan Esophageal Society. Comprehensive Registry of Esophageal Cancer in Japan, 2010. Esophagus 2017; 14 (03) 189-214
    CrossrefPubMedGoogle Scholar
  • 10 Chen H, Lu JJ, Zhou J. et al. Anterior versus posterior routes of reconstruction after esophagectomy: a comparative anatomic study. Ann Thorac Surg 2009; 87 (02) 400-404
    CrossrefPubMedGoogle Scholar
  • 11 Berlth F, Plum PS, Chon SH, Gutschow CA, Bollschweiler E, Hölscher AH. Total minimally invasive esophagectomy for esophageal adenocarcinoma reduces postoperative pain and pneumonia compared to hybrid esophagectomy. Surg Endosc 2018; 32 (12) 4957-4965
    CrossrefPubMedGoogle Scholar
  • 12 Tapias LF, Morse CR. Minimally invasive Ivor Lewis esophagectomy: description of a learning curve. J Am Coll Surg 2014; 218 (06) 1130-1140
    CrossrefPubMedGoogle Scholar
  • 13 Chen L, Liu X, Wang R. et al. Minimally invasive esophagectomy for esophageal cancer according to the location of the tumor: experience of 251 patients. Ann Med Surg (Lond) 2017; 17: 54-60
    CrossrefPubMedGoogle Scholar
  • 14 Zheng YZ, Dai SQ, Li W. et al. Comparison between different reconstruction routes in esophageal squamous cell carcinoma. World J Gastroenterol 2012; 18 (39) 5616-5621
    CrossrefPubMedGoogle Scholar
  • 15 Yamasaki M, Miyata H, Yasuda T. et al. Impact of the route of reconstruction on post-operative morbidity and malnutrition after esophagectomy: a multicenter cohort study. World J Surg 2015; 39 (02) 433-440
    CrossrefPubMedGoogle Scholar
  • 16 Coral RP, Constant-Neto M, Silva IS. et al. Comparative anatomical study of the anterior and posterior mediastinum as access routes after esophagectomy. Dis Esophagus 2003; 16 (03) 236-238
    CrossrefPubMedGoogle Scholar
  • 17 Kunisaki C, Makino H, Otsuka Y. et al. Appropriate routes of reconstruction following transthoracic esophagectomy. Hepatogastroenterology 2007; 54 (79) 1997-2002
    PubMedGoogle Scholar
  • 18 Yang YS, Niu ZX, Chen LQ. [Meta-analysis on reconstructions of posterior mediastinal route and anterior mediastinal route after esophagectomy]. Zhonghua Wei Chang Wai Ke Za Zhi 2013; 16 (09) 846-852
    PubMedGoogle Scholar
  • 19 Lv B, Tao YZ, Zhu Y. et al. Comparison of the outcomes between thoracoscopic and laparoscopic esophagectomy via retrosternal and prevertebral lifting paths by the same surgeon. World J Surg Oncol 2017; 15 (01) 166
    CrossrefPubMedGoogle Scholar
  • 20 van Lanschot JJ, van Blankenstein M, Oei HY, Tilanus HW. Randomized comparison of prevertebral and retrosternal gastric tube reconstruction after resection of oesophageal carcinoma. Br J Surg 1999; 86 (01) 102-108
    CrossrefPubMedGoogle Scholar
  • 21 van Lanschot JJ, Hop WC, Voormolen MH, van Deelen RA, Blomjous JG, Tilanus HW. Quality of palliation and possible benefit of extra-anatomic reconstruction in recurrent dysphagia after resection of carcinoma of the esophagus. J Am Coll Surg 1994; 179 (06) 705-713
    PubMedGoogle Scholar
  • 22 Urschel JD, Urschel DM, Miller JD, Bennett WF, Young JE. A meta-analysis of randomized controlled trials of route of reconstruction after esophagectomy for cancer. Am J Surg 2001; 182 (05) 470-475
    CrossrefPubMedGoogle Scholar
  • 23 Anegg U, Lindenmann J, Maier A, Smolle J, Smolle-Jüttner FM. Influence of route of gastric transposition on oxygen supply at cervical oesophagogastric anastomoses. Br J Surg 2008; 95 (03) 344-349
    CrossrefPubMedGoogle Scholar