Evidence map›Paper›PMID 40108066›Full record

ArticleEsophagus : official journal of the Japan Esophageal Society2025

The correlation between intrathoracic herniation of the gastric tube and postoperative complications and the efficacy of laparoscopic retrosternal route creation.

Yutaka Kishimoto, Koji Otsuka, Takeshi Yamashita, Akira Saito, Masahiro Kohmoto, Kentaro Motegi, Tomotake Ariyoshi, Satoru Goto, Masahiko Murakami, Takeshi Aoki

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Esophagus : official journal of the Japan Esophageal Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yutaka KishimotoDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Koji OtsukaDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan. kojiotsuka@med.showa-u.ac.jp.ORCID 0000-0002-9625-785X
Takeshi YamashitaDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Akira SaitoDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Masahiro KohmotoDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Kentaro MotegiDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Tomotake AriyoshiDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Satoru GotoDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.
Masahiko MurakamiEsophageal Cancer Center, Showa University Hospital, 1-5-8, Hatanodai, Sinagawa-ku, Tokyo, 142-8666, Japan.
Takeshi AokiDepartment of Gastrointestinal and General Surgery, School of Medicine, Showa University, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGastric tube prolapse into the thoracic cavity in retrosternal route reconstruction during esophagectomy is known as intrathoracic herniation of the gastric tube (IHGT). However, few reports have determined whether a correlation exists between IHGT and postoperative complications. Moreover, the optimal procedure for avoiding IHGT remains unclear.

methodsThis retrospective study included 200 patients who had undergone subtotal esophagectomy and retrosternal gastric tube reconstruction at a single institution. The diagnosis of IHGT was defined as a gastric tube herniation length of ≥ 5 cm on plain chest radiography. The frequency of postoperative complications in patients with IHGT was measured to determine any correlation. The incidence of IHGT in a laparoscopic retrosternal route creation group was also measured and the efficacy of this procedure was investigated.

resultsThe overall incidence of IHGT was 7.5%. The incidence of grade II or higher anastomotic leakage and atelectasis was significantly higher in the IHGT( +) (anastomotic leakage, 26.7% vs. 4.3%, P = 0.007; atelectasis, 40.0% vs. 13.5%, P = 0.016). In univariate analysis, IHGT( +) showed a significantly higher incidence of anastomotic leakage (OR 7.88, P = 0.007). In multivariate analysis, IHGT was an independent risk factor for atelectasis (OR 5.03, P = 0.005). Furthermore, the incidence of IHGT was significantly lower in the laparoscopic group (2.0% vs. 13.0%, P = 0.005).

conclusionOur findings show that IHGT may be correlated with grade II or higher anastomotic leakage and atelectasis. Laparoscopic retrosternal route creation may be effective in avoiding IHGT and contributes to a reduction in postoperative complications.

Indexed as

Esophageal NeoplasmsEsophagectomyHerniaLaparoscopyPostoperative ComplicationsStomachAgedAnastomotic LeakFemaleHumansIncidenceMaleMiddle AgedPulmonary AtelectasisRetrospective StudiesTreatment OutcomeDelayed gastric conduit emptyingEsophagectomyIntrathoracic herniationPostoperative complicationRetrosternal route

Identifiers

PMID40108066
PMCPMC12167243

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.