OBJECTIVETo compare the outcome between retrosternal and posterior mediastinal gastric tube reconstruction after three-phase esophagectomy.

METHODSA total of 107 patients who underwent three-phase esophagectomy between July 2005 and May 2009 were enrolled in this study.

RESULTSThere were 78 men and 29 women. Median age was 62.1 years. The tumor located at upper segment in 20 cases, middle segment in 69 cases and lower segment in 18 cases. There were 55 patients in the posterior mediastinal group and 52 in the retrosternal group. There were no significant differences between two groups in operation time, intraoperative blood loss, duration of chest tube. Hospital stay of retrosternal group was longer as compared to posterior mediastinal group. No death occurred in both groups. Anastomotic leakage occurred more frequently in retrosternal group than that in posterior mediastinal group (26.9% vs 5.5%). Postoperative pneumonia, atelectasis and arrhythmia were not significantly different between two groups.

CONCLUSIONSAfter three-phase esophagectomy, both retrosternal and posterior mediastinal gastric tube reconstruction can be performed easily and safely. Morbidity of anastomotic leakage is higher in retrosternal reconstruction. Individualized gastric tube reconstruction should be considered.