{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T22:47:16Z","timestamp":1781131636522,"version":"3.54.1"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,6]],"date-time":"2024-01-06T00:00:00Z","timestamp":1704499200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,6]],"date-time":"2024-01-06T00:00:00Z","timestamp":1704499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Substernal (ST) and posterior mediastinal (PM) routes are the two most common for reconstruction after esophagectomy with cervical anastomosis. Recent evidence showed similar outcomes between the routes; thus, the superior choice remained controversial. This study aimed to compare the short-term outcomes of the ST to the PM route for reconstruction after esophagectomy for esophageal cancer (EC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>This retrospective cohort study included 132 patients who underwent McKeown minimally invasive esophagectomy (MIE) with gastric conduit for EC between March 2015 and December 2022. Among these, 89 and 43 patients received the ST route and PM route for reconstruction, respectively. Short-term outcomes including operative characteristics, postoperative morbidity, and mortality were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Result<\/jats:title>\n                    <jats:p>There was no conversion from ST to PM route. The ST group had longer operating time (375\u00a0min vs. 341\u00a0min). Oral feeding initiation, postoperative hospital stays, and overall complication rates were comparable in the two groups. The rate and severity of anastomotic leakage were similar between the groups. The ST group had a significantly lower incidence of postoperative ICU admission and pneumonia compared to the PM group (5.6% vs. 16.3% and 19.1% vs. 37.2%, respectively). Azygos vein bleeding, obstruction at feeding jejunostomy site, and conduit\u2013trachea fistula were severe complications that only occurred in PM route.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ST route was superior to PM route in term of postoperative ICU admission and pneumonia. This route may prevent severe complications that only occur in PM route. ST route can be favorable option for reconstruction after McKeown MIE for EC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-023-03215-6","type":"journal-article","created":{"date-parts":[[2024,1,6]],"date-time":"2024-01-06T01:01:41Z","timestamp":1704502901000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparison of substernal and posterior mediastinal route of reconstruction after minimally invasive esophagectomy for esophageal cancer"],"prefix":"10.1007","volume":"409","author":[{"given":"Tran Quang","family":"Dat","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dang Quang","family":"Thong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doan Thuy","family":"Nguyen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Viet","family":"Hai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Hoang","family":"Bac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7088-5532","authenticated-orcid":false,"given":"Vo Duy","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,6]]},"reference":[{"issue":"3","key":"3215_CR1","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","volume":"71","author":"H Sung","year":"2021","unstructured":"Sung H et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209\u2013249","journal-title":"CA Cancer J Clin"},{"issue":"10125","key":"3215_CR2","doi-asserted-by":"publisher","first-page":"1023","DOI":"10.1016\/S0140-6736(17)33326-3","volume":"391","author":"C Allemani","year":"2018","unstructured":"Allemani C et al (2018) Global surveillance of trends in cancer survival 2000\u201314 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 391(10125):1023\u20131075","journal-title":"Lancet"},{"issue":"2","key":"3215_CR3","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1097\/SLA.0000000000002611","volume":"269","author":"DE Low","year":"2019","unstructured":"Low DE et al (2019) Benchmarking complications associated with esophagectomy. Ann Surg 269(2):291\u2013298","journal-title":"Ann Surg"},{"issue":"Suppl 8","key":"3215_CR4","doi-asserted-by":"publisher","first-page":"S826","DOI":"10.21037\/jtd.2017.03.173","volume":"9","author":"F van Workum","year":"2017","unstructured":"van Workum F et al (2017) McKeown or Ivor Lewis totally minimally invasive esophagectomy for cancer of the esophagus and gastroesophageal junction: systematic review and meta-analysis. J Thorac Dis 9(Suppl 8):S826-s833","journal-title":"J Thorac Dis"},{"issue":"9829","key":"3215_CR5","doi-asserted-by":"publisher","first-page":"1887","DOI":"10.1016\/S0140-6736(12)60516-9","volume":"379","author":"SS Biere","year":"2012","unstructured":"Biere SS et al (2012) Minimally invasive versus open oesophagectomy for patients with oesophageal cancer: a multicentre, open-label, randomised controlled trial. Lancet 379(9829):1887\u20131892","journal-title":"Lancet"},{"issue":"2","key":"3215_CR6","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1007\/s00268-014-2819-1","volume":"39","author":"M Yamasaki","year":"2015","unstructured":"Yamasaki M et al (2015) Impact of the route of reconstruction on post-operative morbidity and malnutrition after esophagectomy: a multicenter cohort study. World J Surg 39(2):433\u2013440","journal-title":"World J Surg"},{"issue":"1","key":"3215_CR7","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1046\/j.1365-2168.1999.00981.x","volume":"86","author":"JJ van Lanschot","year":"1999","unstructured":"van Lanschot JJ et al (1999) Randomized comparison of prevertebral and retrosternal gastric tube reconstruction after resection of oesophageal carcinoma. Br J Surg 86(1):102\u2013108","journal-title":"Br J Surg"},{"issue":"9","key":"3215_CR8","first-page":"846","volume":"16","author":"YS Yang","year":"2013","unstructured":"Yang YS, Niu ZX, Chen LQ (2013) Meta-analysis on reconstructions of posterior mediastinal route and anterior mediastinal route after esophagectomy. Zhonghua Wei Chang Wai Ke Za Zhi 16(9):846\u2013852","journal-title":"Zhonghua Wei Chang Wai Ke Za Zhi"},{"issue":"3","key":"3215_CR9","doi-asserted-by":"publisher","first-page":"209","DOI":"10.1159\/000070387","volume":"20","author":"AC Wong","year":"2003","unstructured":"Wong AC, Law S, Wong J (2003) Influence of the route of reconstruction on morbidity, mortality and local recurrence after esophagectomy for cancer. Dig Surg 20(3):209\u2013214","journal-title":"Dig Surg"},{"issue":"8","key":"3215_CR10","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1111\/j.1442-2050.2011.01309.x","volume":"25","author":"T Yasuda","year":"2012","unstructured":"Yasuda T et al (2012) Ten cases of gastro-tracheobronchial fistula: a serious complication after esophagectomy and reconstruction using posterior mediastinal gastric tube. Dis Esophagus 25(8):687\u2013693","journal-title":"Dis Esophagus"},{"issue":"2","key":"3215_CR11","doi-asserted-by":"publisher","first-page":"364","DOI":"10.1016\/j.jss.2015.11.030","volume":"201","author":"J Yang","year":"2016","unstructured":"Yang J et al (2016) Esophageal reconstruction: posterior mediastinal or retrosternal route. J Surg Res 201(2):364\u2013369","journal-title":"J Surg Res"},{"issue":"2","key":"3215_CR12","doi-asserted-by":"publisher","first-page":"231","DOI":"10.1007\/s11605-015-3033-7","volume":"20","author":"OM Crespin","year":"2016","unstructured":"Crespin OM et al (2016) Hiatal herniation after transhiatal esophagectomy: an underreported complication. J Gastrointest Surg 20(2):231\u2013236","journal-title":"J Gastrointest Surg"},{"issue":"2","key":"3215_CR13","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1007\/s00268-004-7568-0","volume":"29","author":"IE Katsoulis","year":"2005","unstructured":"Katsoulis IE et al (2005) Duodenogastric reflux after esophagectomy and gastric pull-up: the effect of the route of reconstruction. World J Surg 29(2):174\u2013181","journal-title":"World J Surg"},{"issue":"1","key":"3215_CR14","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1186\/s12957-017-1219-z","volume":"15","author":"B Lv","year":"2017","unstructured":"Lv B et al (2017) Comparison of the outcomes between thoracoscopic and laparoscopic esophagectomy via retrosternal and prevertebral lifting paths by the same surgeon. World J Surg Oncol 15(1):166","journal-title":"World J Surg Oncol"},{"issue":"12","key":"3215_CR15","doi-asserted-by":"publisher","first-page":"5040","DOI":"10.21037\/jtd.2017.11.51","volume":"9","author":"JR Moremen","year":"2017","unstructured":"Moremen JR et al (2017) Substernal reconstruction following esophagectomy: operation of last resort? J Thorac Dis 9(12):5040\u20135045","journal-title":"J Thorac Dis"},{"issue":"4","key":"3215_CR16","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1002\/ags3.12685","volume":"7","author":"E Booka","year":"2023","unstructured":"Booka E et al (2023) What is the best reconstruction procedure after esophagectomy? A meta-analysis comparing posterior mediastinal and retrosternal approaches. Ann Gastroenterol Surg 7(4):553\u2013564","journal-title":"Ann Gastroenterol Surg"},{"key":"3215_CR17","doi-asserted-by":"crossref","unstructured":"Kurahashi Y et al (2021) Anastomosis behind the sternoclavicular joint is associated with increased incidence of anastomotic stenosis in retrosternal reconstruction with a gastric conduit after esophagectomy. Dis Esophagus 34(4):doaa089","DOI":"10.1093\/dote\/doaa089"},{"issue":"11","key":"3215_CR18","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1016\/j.jcma.2011.09.006","volume":"74","author":"ML Chan","year":"2011","unstructured":"Chan ML et al (2011) Reconstruction after esophagectomy for esophageal cancer: retrosternal or posterior mediastinal route? J Chin Med Assoc 74(11):505\u2013510","journal-title":"J Chin Med Assoc"},{"issue":"4","key":"3215_CR19","doi-asserted-by":"publisher","first-page":"2680","DOI":"10.1007\/s00464-021-08745-y","volume":"36","author":"M Horikawa","year":"2022","unstructured":"Horikawa M et al (2022) Laparoscopic creation of a retrosternal route for gastric conduit reconstruction. Surg Endosc 36(4):2680\u20132687","journal-title":"Surg Endosc"},{"issue":"5","key":"3215_CR20","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1016\/S0002-9610(01)00763-2","volume":"182","author":"JD Urschel","year":"2001","unstructured":"Urschel JD et al (2001) A meta-analysis of randomized controlled trials of route of reconstruction after esophagectomy for cancer. Am J Surg 182(5):470\u2013475","journal-title":"Am J Surg"},{"issue":"1","key":"3215_CR21","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1007\/s10388-018-0642-8","volume":"16","author":"Y Kitagawa","year":"2019","unstructured":"Kitagawa Y et al (2019) Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: part 2. Esophagus 16(1):25\u201343","journal-title":"Esophagus"},{"issue":"1","key":"3215_CR22","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s10388-018-0641-9","volume":"16","author":"Y Kitagawa","year":"2019","unstructured":"Kitagawa Y et al (2019) Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus 16(1):1\u201324","journal-title":"Esophagus"},{"issue":"2","key":"3215_CR23","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1097\/SLA.0b013e3181b13ca2","volume":"250","author":"PA Clavien","year":"2009","unstructured":"Clavien PA et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 250(2):187\u2013196","journal-title":"Ann Surg"},{"issue":"2","key":"3215_CR24","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1097\/SLA.0000000000001098","volume":"262","author":"DE Low","year":"2015","unstructured":"Low DE et al (2015) International consensus on standardization of data collection for complications associated with esophagectomy: Esophagectomy Complications Consensus Group (ECCG). Ann Surg 262(2):286\u2013294","journal-title":"Ann Surg"},{"issue":"79","key":"3215_CR25","first-page":"1997","volume":"54","author":"C Kunisaki","year":"2007","unstructured":"Kunisaki C et al (2007) Appropriate routes of reconstruction following transthoracic esophagectomy. Hepatogastroenterology 54(79):1997\u20132002","journal-title":"Hepatogastroenterology"},{"key":"3215_CR26","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1097\/SLA.0b013e3182480a6a","volume":"255","author":"N Blencowe","year":"2012","unstructured":"Blencowe N et al (2012) Reporting of short-term clinical outcomes after esophagectomy a systematic review. Ann Surg 255:658\u2013666","journal-title":"Ann Surg"},{"issue":"39","key":"3215_CR27","doi-asserted-by":"publisher","first-page":"5616","DOI":"10.3748\/wjg.v18.i39.5616","volume":"18","author":"YZ Zheng","year":"2012","unstructured":"Zheng YZ et al (2012) Comparison between different reconstruction routes in esophageal squamous cell carcinoma. World J Gastroenterol 18(39):5616\u20135621","journal-title":"World J Gastroenterol"},{"issue":"3","key":"3215_CR28","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1016\/j.suc.2019.02.011","volume":"99","author":"IW Mboumi","year":"2019","unstructured":"Mboumi IW, Reddy S, Lidor AO (2019) Complications after esophagectomy. Surg Clin North Am 99(3):501\u2013510","journal-title":"Surg Clin North Am"}],"container-title":["Langenbeck's Archives of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-023-03215-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00423-023-03215-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00423-023-03215-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,9]],"date-time":"2024-01-09T05:06:09Z","timestamp":1704776769000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00423-023-03215-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,6]]},"references-count":28,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["3215"],"URL":"https:\/\/doi.org\/10.1007\/s00423-023-03215-6","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3644748\/v1","asserted-by":"object"}]},"ISSN":["1435-2451"],"issn-type":[{"value":"1435-2451","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,6]]},"assertion":[{"value":"21 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"28 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The study was conducted according to the guidelines of the Declaration of Helsinki and approved by Institutional Review Board, University Medical Center Ho Chi Minh city.Approval to perform research on human subjects in this study was provided by the Institutional Review Board, University Medical Center Ho Chi Minh city (registration number: 76\/GCN-HDDD).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Drs. Tran Quang Dat, Dang Quang Thong, Doan Thuy Nguyen, Nguyen Viet Hai, Nguyen Hoang Bac, and Vo Duy Long disclose any potential or actual personal, political, or financial conflict of interest in the material, information, or techniques described in the paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"27"}}