Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Dig Surg. 2017;34(6):483-488. doi: 10.1159/000456084. Epub 2017 Feb 10.
Intrathoracic herniation of gastric tube (IHGT) pull-up via the retrosternal route is a rare complication following esophagectomy, which is caused due to an injury in the parietal pleura during a blunt dissection of the retrosternal space. However, little is known regarding the clinical impact of IHGT pull-up via the retrosternal route.
Clinical data of 231 patients receiving gastric tube reconstruction via the retrosternal route following esophagectomy were collected from medical charts.
Of the 231 patients, 19 (8%) developed IHGT. Vocal cord palsy, particularly with delayed onset, developed at a significantly high frequency in the group of patients with IHGT. There were no significant differences in the frequency of other surgical complications.
This is the first report to examine the clinical impact of IHGT pull-up via the retrosternal route. Vocal cord palsy, particularly with delayed onset, developed in the group of patients with IHGT. Therefore, when reconstruction is performed via the retrosternal route, it is very important that blunt and blind dissection of the retrosternal space be performed with extreme care to prevent pleural injury.
经胸骨后路径发生的胃管内疝（IHGT）提拉是食管切除术后一种罕见的并发症，其由胸骨后空间钝性解剖过程中壁层胸膜损伤引起。然而，对于经胸骨后路径发生的 IHGT 提拉的临床影响知之甚少。
从病历中收集了 231 例接受食管切除术后经胸骨后路径重建胃管的患者的临床数据。
在 231 例患者中，19 例（8%）发生 IHGT。在 IHGT 组中，声带麻痹，特别是迟发性声带麻痹的发生率明显较高。其他手术并发症的发生率无显著差异。
这是首次研究经胸骨后路径发生的 IHGT 提拉的临床影响的报告。在 IHGT 组中，出现了声带麻痹，特别是迟发性声带麻痹。因此，当经胸骨后路径进行重建时，非常重要的是要格外小心地进行胸骨后空间的钝性和盲目解剖，以防止胸膜损伤。
