Wahl der Rekonstruktionsroute nach Ösophagektomie

Abstract

Retrosternal reconstruction shows an increased rate of postoperative nonsurgical complications and a slightly increased mortality compared to posterior mediastinal reconstruction. Radionuclid transit through the gastric tube is significantly longer in either way of reconstruction compared to normal controls. Tracer retention is significantly increased after retrosternal reconstruction. This however has no impact on the patients' quality of life. We therefore recommend posterior mediastinal reconstruction provided that curative resection is definitely achieved in order to avoid possible complications by local recurrence. In the palliative situation we prefer the retrosternal route of reconstruction as the functional disadvantages had no negative effect on quality of life and the general disadvantages seem to be neglectable in this situation. The same is true if adjuvant radiation of the tumor bed is planned. Pyloroplasty in our opinion is not necessary. The presternal route of reconstruction is underrepresented in the literature. In our experience it has no indication.