Reconstruction after esophagectomy for esophageal cancer: retrosternal or posterior mediastinal route?

ABSTRACT

BACKGROUND: The aim of this study is to investigate which reconstructive route is most appropriate for patients undergoing an esophagectomy for esophageal cancer. METHODS: Clinical data on 110 patients were retrospectively collected by reviewing their medical charts. In order to evaluate the effects of adjuvant radiotherapy, patients were interviewed about the adverse side effects they experienced during and after treatment. RESULTS: The leakage rate was significantly lower in group that received posterior mediastinal reconstruction compared with the group that received retrosternal reconstruction (7.1% vs. 39%, p = 0.01). There were no significant differences between groups in terms of side effects related to adjuvant chemoradiotherapy or radiotherapy. The quality-of-life reports of patients who received adjuvant radiotherapy were not significantly different between the two study groups. CONCLUSION: For patients with esophageal cancer who undergo an esophagectomy followed by gastric conduit reconstruction, the posterior mediastinal route is superior to the retrosternal route in regard to anastomotic leakage and hospital mortality. Adjuvant radiotherapy did not influence the postoperative functions of the gastric conduit used for reconstruction in either route.