{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:03:15Z","timestamp":1772582595463,"version":"3.50.1"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T00:00:00Z","timestamp":1626134400000},"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":["surg case rep"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The narrowness of the thoracic inlet is often a problem in retrosternal reconstruction after esophagectomy. We report here three cases in which compression of the gastric conduit behind the sternoclavicular joint possibly caused anastomotic leakage.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentations<\/jats:title>\n                <jats:p>The first case was a 71-year-old man who underwent subtotal esophagectomy for upper esophageal cancer followed by retrosternal reconstruction. On postoperative day 2, he developed septic shock and underwent reoperation because of a necrotic gastric conduit. The tip of the conduit above the manubrium was necrotic due to strangulation as a result of compression by the sternoclavicular joint. The second and third cases were a 50-year-old woman and a 71-year-old man who underwent subtotal esophagectomy for middle and lower esophageal cancer, respectively, followed by retrosternal reconstruction. Despite indocyanine green fluorescence imaging indicating adequate blood flow in both cases, the tip of the conduit appeared pale and congested because of compression by the sternoclavicular joint after anastomosis. Postoperatively, these two patients developed anastomotic leakage that was confirmed endoscopically on the ventral side of the gastric wall that had been pale intraoperatively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>When performing reconstruction using the retrosternal route after esophagectomy, it is important to ensure that compression by the sternoclavicular joint does not have an adverse impact on blood flow at the tip of the gastric conduit.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-021-01250-3","type":"journal-article","created":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T14:03:14Z","timestamp":1626184994000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anastomotic leakage after esophagectomy possibly caused by compression of the gastric conduit behind the sternoclavicular joint: a report of three cases"],"prefix":"10.1186","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4694-3413","authenticated-orcid":false,"given":"Yasunori","family":"Kurahashi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yudai","family":"Hojo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuro","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Kumamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinori","family":"Ishida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisashi","family":"Shinohara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,7,13]]},"reference":[{"key":"1250_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/dote\/doaa089","volume":"34","author":"Y Kurahashi","year":"2021","unstructured":"Kurahashi Y, Ishida Y, Kumamoto T, Igeta M, Takemura M, Shinohara H, et al. Anastomosis behind the sternoclavicular joint is associated with increased incidence of anastomotic stenosis in retrosternal reconstruction with a gastric conduit after esophagectomy. Dis Esophagus. 2021;34:1\u20138.","journal-title":"Dis Esophagus"},{"key":"1250_CR2","first-page":"98","volume":"55","author":"C Kunisaki","year":"2008","unstructured":"Kunisaki C, Makino H, Akiyama H, Nomura M, Otsuka Y, Ono HA, et al. Predictive factors for anastomotic leakage in the neck after retrosternal reconstruction for esophageal cancer. Hepatogastroenterology. 2008;55:98\u2013102.","journal-title":"Hepatogastroenterology"},{"key":"1250_CR3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1007\/s10388-019-00705-9","volume":"17","author":"S Inoue","year":"2020","unstructured":"Inoue S, Yoshida T, Nishino T, Goto M, Furukita Y, Yamamoto Y, et al. The sterno-tracheal distance is an important factor of anastomotic leakage of retrosternal gastric tube reconstruction after esophagectomy. Esophagus. 2020;17:264\u20139.","journal-title":"Esophagus"},{"key":"1250_CR4","doi-asserted-by":"publisher","first-page":"2598","DOI":"10.1007\/s00268-017-4047-y","volume":"41","author":"S Mine","year":"2017","unstructured":"Mine S, Watanabe M, Okamura A, Imamura Y, Kajiyama Y, Sano T. Superior thoracic aperture size is significantly associated with cervical anastomotic leakage after esophagectomy. World J Surg. 2017;41:2598\u2013604.","journal-title":"World J Surg"},{"key":"1250_CR5","doi-asserted-by":"publisher","first-page":"e4386","DOI":"10.1097\/MD.0000000000004386","volume":"95","author":"K Koyanagi","year":"2016","unstructured":"Koyanagi K, Ozawa S, Oguma J, Kazuno A, Yamazaki Y, Ninomiya Y, et al. Blood flow speed of the gastric conduit assessed by indocyanine green fluorescence. New predictive evaluation of anastomotic leakage after esophagectomy. Medicine. 2016;95:e4386.","journal-title":"Medicine"},{"key":"1250_CR6","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/j.jamcollsurg.2015.04.022","volume":"221","author":"T Yukaya","year":"2015","unstructured":"Yukaya T, Saeki H, Kasagi Y, Nakashima Y, Ando K, Imamura Y, et al. Indocyanine green fluorescence angiography for quantitative evaluation of gastric tube perfusion in patients undergoing esophagectomy. Am Coll Surg. 2015;221:e37-42.","journal-title":"Am Coll Surg"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-021-01250-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-021-01250-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-021-01250-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,13]],"date-time":"2021-07-13T14:12:17Z","timestamp":1626185537000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-021-01250-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,13]]},"references-count":6,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["1250"],"URL":"https:\/\/doi.org\/10.1186\/s40792-021-01250-3","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,13]]},"assertion":[{"value":"20 May 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 July 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Informed consent was obtained from the patients for publication of this report and the use of any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"163"}}