ArticleJournal of thoracic disease2026
Endoscopic accessibility and conduit passage after retrosternal
Article in Journal of thoracic disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
Background: The optimal route for gastric-conduit reconstruction after McKeown esophagectomy remains uncertain. Previous comparisons have focused primarily on anastomotic leakage and pulmonary morbidity, whereas postoperative endoscopic accessibility and clinically evident conduit-passage disturbance have been less well characterized. We compared retrosternal (RS) and posterior mediastinal (PM) reconstruction, focusing on these functional outcomes. Methods: This single-center retrospective cohort included 37 patients treated by the same surgical team between March 2025 and April 2026 (RS, n=14; PM, n=23). Upper gastrointestinal contrast assessment was generally performed at approximately 2 weeks and routine postoperative endoscopy at approximately 3 weeks, unless endoscopy was contraindicated or not feasible. Endoscopy time and route-related difficulty were evaluated at the examination level. Clinically evident passage disturbance, defined as dysphagia with retained food or impaired bolus transit requiring endoscopic confirmation or treatment, was evaluated at the patient level during 3 months of follow-up. Early and late delayed gastric conduit emptying (DGCE) and secondary perioperative outcomes were also assessed. All comparisons were unadjusted and exploratory. Results: Among examinations with recorded duration (13 RS and 24 PM), median endoscopy time was longer after RS reconstruction [14.00 (8.00, 17.00) Conclusions: RS reconstruction was associated with longer examination-level endoscopy time and four stricture-related passage-disturbance events in this small cohort, whereas no statistically detectable route-related difference in DGCE was observed. These unadjusted findings are hypothesis-generating and do not establish the superiority of either route. Larger prospective studies incorporating standardized endoscopic assessment, route-geometry measures, validated dysphagia instruments, and longitudinal functional outcomes are warranted.
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