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Substernal reconstruction following esophagectomy: operation of last resort?

  
@article{JTD17778,
	author = {Jacob R. Moremen and DuyKhanh P. Ceppa and Karen M. Rieger and Thomas J. Birdas},
	title = {Substernal reconstruction following esophagectomy: operation of last resort?},
	journal = {Journal of Thoracic Disease},
	volume = {9},
	number = {12},
	year = {2017},
	keywords = {},
	abstract = {Background: The posterior mediastinum is the preferred location for reconstruction following esophagectomy. Occasionally alternative routes are required. We examined patient outcomes of esophageal reconstruction in order to determine whether substernal reconstruction (SR) is an equivalent alternative to orthotopic placement.
Methods: Following IRB approval, we performed a retrospective review of all patients who underwent an esophagectomy from 1988–2014. Only patients reconstructed with a gastric conduit and cervical anastomosis by either substernal or posterior mediastinal (PM) routes were included in the study. Endpoints assessed included anastomotic leak rate, post-operative complications, reoperation, hospital length of stay, and 30- and 90-day mortality. 
Results: Thirty-three patients underwent SR and 182 had a PM gastric conduit with cervical anastomosis. The SR pathology was predominantly benign while PM was mostly malignant. Sixteen SR patients had a delayed reconstruction after prior diversion. Mean hospital LOS was longer in the SR group (P},
	issn = {2077-6624},	url = {https://jtd.amegroups.org/article/view/17778}
}