[The route of reconstruction following esophagectomy]

The route of reconstruction following esophagectomy.Retrosternal reconstruction shows an increased rate of postoperative non-surgical 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. Tracerretention 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 would rather choose 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 tumorbed is planned. Pyloroplasty in our opinion is unnecessary. The presternal route of reconstruction is underrepresented in the literature. In our experience it has no indication.