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The sterno-tracheal distance is an important factor of anastomotic leakage of retrosternal gastric tube reconstruction after esophagectomy
- Source :
- Esophagus. 17:264-269
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- Anastomotic leakage (AL) is a serious complication after esophagectomy. The retrosternal (RS) route has been selected majorly to reduce reflux and related pneumonia and considering mediastinal recurrences. AL has been developed more in RS than posterior mediastinal (PM) route reconstruction. Therefore, we suspected the sterno-tracheal distance (STD) might be related to AL and started the selection according to the STD from 2009. A total of 221 patients who underwent a subtotal esophagectomy with gastric tube reconstruction during January 2004–April 2017 were investigated. The patients were classified into the ‘after STD selection’ (A; n = 144) group and the ‘before STD selection’ (B, n = 77) group. The incidences of and the risk factors for AL between the two groups were compared. The incidence of AL was high in the B group (18.2%), and 78.6% of the patients who developed AL were treated with RS route reconstruction. The median STDs of the patients with AL and no AL were 10.3 mm and 14.5 mm, respectively (p = 0.001). These results demonstrated that the STD was a risk factor for AL in the RS route. Based on these results, 13 mm was set as the cutoff value. After STD selection, the median STD increased from 14.0 to 17.3 mm (p = 0.001), and the incidence of AL decreased significantly from 26.2 to 11.1% in the RS route (p = 0.037). The STD was the independent risk factor for AL in the RS route. RS route reconstruction should be avoided for the patients with STD
- Subjects :
- Male
Sternum
medicine.medical_specialty
Esophageal Neoplasms
medicine.medical_treatment
Anastomotic Leak
Enteral Nutrition
Postoperative Complications
Japan
Risk Factors
Preoperative Care
medicine
Humans
Risk factor
Aged
Retrospective Studies
business.industry
Incidence
Incidence (epidemiology)
Mediastinum
Gastroenterology
Reflux
Middle Aged
Plastic Surgery Procedures
Subtotal esophagectomy
Surgery
Esophagectomy
Trachea
Cardiothoracic surgery
Anastomotic leakage
Case-Control Studies
Female
Tomography, X-Ray Computed
business
Complication
Subjects
Details
- ISSN :
- 16129067 and 16129059
- Volume :
- 17
- Database :
- OpenAIRE
- Journal :
- Esophagus
- Accession number :
- edsair.doi.dedup.....67ff012cb30e81281f0b61af550a12b2