Randomized comparison of prevertebral and retrosternal gastric tube reconstruction after resection of oesophageal carcinoma
Methods: Sixty patients underwent resection of a carcinoma of the oesophagus or gastro-oesophageal junction with curative intent. Subsequently, these patients were randomly allocated to either prevertebral (n=30) or retrosternal (n=30) gastric tube reconstruction. Early and late complications and functional results were carefully monitored.
Results: Creation of the retrosternal tunnel was not accompanied by any perioperative complications. Postoperative recovery, anastomotic leakage and benign stricture formation were not significantly different between the two groups. Functional results, as measured by scintigraphic gastric emptying, quantitative and qualitative oral food intake, and changes in body-weight were similar in the two groups.
Conclusion: After subtotal oesophagectomy retrosternal gastric tube reconstruction can be performed easily and safely, and gives functional results similar to those obtained with prevertebral reconstruction. In patients at high risk for developing secondary malignant dysphagia the extra-anatomical route is the reconstruction of first choice.
Document Type: Research Article
Affiliations: 1: Department of Surgery, University Hospital Dijkzigt, Rotterdam, The Netherlands 2: Department of Gastgroenterology, University Hospital Dijkzigt, Rotterdam, The Netherlands 3: Department of Nuclear Medicine, University Hospital Dijkzigt, Rotterdam, The Netherlands
Publication date: January 1, 1999