{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:42:47Z","timestamp":1781228567095,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2014,10,15]],"date-time":"2014-10-15T00:00:00Z","timestamp":1413331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2014,10,15]],"date-time":"2014-10-15T00:00:00Z","timestamp":1413331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Reconstruction after esophagectomy is mainly performed through the retrosternum (RS) or posterior mediastinum (PM). However, the best approach is not clear. This study aimed to assess the impact of the route of gastric conduit reconstruction, after esophagectomy for esophageal squamous cell carcinoma (ESCC), on post\u2010operative outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed 298 patients who underwent radical esophagectomy for ESCC at three high volume centers between 2008 and 2009. Among them, the RS was selected in 166 patients and PM in 118; while, the antethoracic route was used in 14 patients. Post\u2010operative morbidity, mortality, and long\u2010term outcome were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were no differences between patients of the two routes with respect to operative blood loss (RS: 753 \u00b1 519, PM: 748 \u00b1 414 g) and post\u2010operative complications, including pulmonary problems (RS: 15 %, PM: 10.2 %) and anastomotic leakage (RS: 9.0 %, PM: 5.1 %); although, the operating time (RS: 566 \u00b1 97, PM: 472 \u00b1 79\u00a0min; <jats:italic>p<\/jats:italic> &lt; 0.0001) was shorter in the PM group than the RS group. The percentage weight loss after surgery was significantly less in the PM group than the RS group at 1 year (8.6 vs. 11.1 %; <jats:italic>p<\/jats:italic> = 0.025); although, the percentage at discharge was not different between the groups (PM: 4.9 %, RS: 6.3 %; <jats:italic>p<\/jats:italic> = 0.072). Multivariate analysis identified pre\u2010operative body weight and the reconstruction route as significant and independent factors associated with 1\u2010year weight loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results indicate gastric tube reconstruction through the posterior mediastinal route after esophagectomy may relieve post\u2010operative 1\u2010year malnutrition without increasing post\u2010operative complications.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-014-2819-1","type":"journal-article","created":{"date-parts":[[2014,10,14]],"date-time":"2014-10-14T17:47:56Z","timestamp":1413308876000},"page":"433-440","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Impact of the Route of Reconstruction on Post\u2010operative Morbidity and Malnutrition after Esophagectomy: A Multicenter Cohort Study"],"prefix":"10.1002","volume":"39","author":[{"given":"Makoto","family":"Yamasaki","sequence":"first","affiliation":[{"name":"Department of Gastroenterological Surgery, Graduate School of Medicine Osaka University 2\u20102\u2010E2, Yamadaoka, Suita 565\u20100879 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Graduate School of Medicine Osaka University 2\u20102\u2010E2, Yamadaoka, Suita 565\u20100879 Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takushi","family":"Yasuda","sequence":"additional","affiliation":[{"name":"Department of Surgery Kinki University School of Medicine, Osaka Sayama Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Osamu","family":"Shiraishi","sequence":"additional","affiliation":[{"name":"Department of Surgery Kinki University School of Medicine, Osaka 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