Clinical Impact of Intrathoracic Herniation of Gastric Tube Pull-Up via the Retrosternal Route following Esophagectomy.
BACKGROUND
Intrathoracic herniation of gastric tube (IHGT) pull-up via the retrosternal route is a rare complication following esophagectomy, which is caused due to an injury in the parietal pleura during a blunt dissection of the retrosternal space. However, little is known regarding the clinical impact of IHGT pull-up via the retrosternal route.


METHODS
Clinical data of 231 patients receiving gastric tube reconstruction via the retrosternal route following esophagectomy were collected from medical charts.


RESULTS
Of the 231 patients, 19 (8%) developed IHGT. Vocal cord palsy, particularly with delayed onset, developed at a significantly high frequency in the group of patients with IHGT. There were no significant differences in the frequency of other surgical complications.


CONCLUSIONS
This is the first report to examine the clinical impact of IHGT pull-up via the retrosternal route. Vocal cord palsy, particularly with delayed onset, developed in the group of patients with IHGT. Therefore, when reconstruction is performed via the retrosternal route, it is very important that blunt and blind dissection of the retrosternal space be performed with extreme care to prevent pleural injury.
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Norihisa
N
Uemura
Tetsuya
T
Abe
Jiro
J
Kawakami
Takahiro
T
Hosoi
Seiji
S
Ito
Yasuhiro
Y
Shimizu
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D004944:Esophagoplasty / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006547:Hernia / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology; D012189:Retrospective Studies; D013270:Stomach / Q000601:surgery*; D013272:Stomach Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D019738:Surgically-Created Structures / Q000009:adverse effects*; D035423:Thoracic Cavity; D014826:Vocal Cord Paralysis / Q000209:etiology*
Esophagectomy; Gastric tube; Intrathoracic herniation; Retrosternal route