A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy
Abstract Background The gastric conduit is the most commonly used replacement organ for reconstruction after minimally invasive McKeown esophagectomy. Although the optimal route of gastric conduit remains controversial, the posterior mediastinal route is physiologically preferable but is not without...
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-024-02718-7 |
| _version_ | 1827276960756137984 |
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| author | Zhaoyang Yan Xinjian Xu Bin Guo Pengzeng Wang Linpeng Niu Zhanjie Gao Yusen Yuan Fei Li Ming He |
| author_facet | Zhaoyang Yan Xinjian Xu Bin Guo Pengzeng Wang Linpeng Niu Zhanjie Gao Yusen Yuan Fei Li Ming He |
| author_sort | Zhaoyang Yan |
| collection | DOAJ |
| description | Abstract Background The gastric conduit is the most commonly used replacement organ for reconstruction after minimally invasive McKeown esophagectomy. Although the optimal route of gastric conduit remains controversial, the posterior mediastinal route is physiologically preferable but is not without disadvantages. Here, we report the safety and efficacy of a method of gastric conduit reconstruction via the anterior of the pulmonary hilum route. Methods We have used the anterior of the pulmonary hilum route since 2021. This procedure involves pulling the gastric conduit up through a substernal tunnel between the right thoracic cavity and the abdominal cavity and passing it into the neck via the anterior of the pulmonary hilum route. In this retrospective study, we compared the clinical outcomes between 20 patients who underwent this procedure and 20 patients who underwent the posterior mediastinal route from 2021 to 2022. Results No mortality was reported in either group. No significant differences were observed between the two groups in duration of surgery, blood loss, incidence of postoperative complications, and postoperative hospital stay. As a result of the anterior of the pulmonary hilum route, the primary tumor bed and lymph node drainage area were effectively bypassed, which facilitates postoperative adjuvant radiotherapy or chemoradiotherapy. The distance of the gastric conduit accompanying the airway was significantly shorter in the anterior of the pulmonary hilum route group. Conclusions Our method is considered to be a safe and useful technique for the reconstruction of gastric conduit. |
| first_indexed | 2024-04-24T07:11:43Z |
| format | Article |
| id | doaj.art-49ba5f28a0464e95b63c99efc1e5bb38 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-04-24T07:11:43Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-49ba5f28a0464e95b63c99efc1e5bb382024-04-21T11:29:49ZengBMCJournal of Cardiothoracic Surgery1749-80902024-04-011911710.1186/s13019-024-02718-7A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomyZhaoyang Yan0Xinjian Xu1Bin Guo2Pengzeng Wang3Linpeng Niu4Zhanjie Gao5Yusen Yuan6Fei Li7Ming He8Department of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceDepartment of Thoracic Surgery, The Fourth Hospital of Hebei Medical University, Hebei Provincial Key Laboratory of Tumor Microenvironment and Drug ResistanceAbstract Background The gastric conduit is the most commonly used replacement organ for reconstruction after minimally invasive McKeown esophagectomy. Although the optimal route of gastric conduit remains controversial, the posterior mediastinal route is physiologically preferable but is not without disadvantages. Here, we report the safety and efficacy of a method of gastric conduit reconstruction via the anterior of the pulmonary hilum route. Methods We have used the anterior of the pulmonary hilum route since 2021. This procedure involves pulling the gastric conduit up through a substernal tunnel between the right thoracic cavity and the abdominal cavity and passing it into the neck via the anterior of the pulmonary hilum route. In this retrospective study, we compared the clinical outcomes between 20 patients who underwent this procedure and 20 patients who underwent the posterior mediastinal route from 2021 to 2022. Results No mortality was reported in either group. No significant differences were observed between the two groups in duration of surgery, blood loss, incidence of postoperative complications, and postoperative hospital stay. As a result of the anterior of the pulmonary hilum route, the primary tumor bed and lymph node drainage area were effectively bypassed, which facilitates postoperative adjuvant radiotherapy or chemoradiotherapy. The distance of the gastric conduit accompanying the airway was significantly shorter in the anterior of the pulmonary hilum route group. Conclusions Our method is considered to be a safe and useful technique for the reconstruction of gastric conduit.https://doi.org/10.1186/s13019-024-02718-7EsophagectomyGastric conduitAnterior of the pulmonary hilum route |
| spellingShingle | Zhaoyang Yan Xinjian Xu Bin Guo Pengzeng Wang Linpeng Niu Zhanjie Gao Yusen Yuan Fei Li Ming He A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy Journal of Cardiothoracic Surgery Esophagectomy Gastric conduit Anterior of the pulmonary hilum route |
| title | A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy |
| title_full | A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy |
| title_fullStr | A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy |
| title_full_unstemmed | A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy |
| title_short | A approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive McKeown esophagectomy |
| title_sort | approach of gastric conduit via the anterior of pulmonary hilum route during minimally invasive mckeown esophagectomy |
| topic | Esophagectomy Gastric conduit Anterior of the pulmonary hilum route |
| url | https://doi.org/10.1186/s13019-024-02718-7 |
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