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Intrathoracic supercharge technique for esophageal reconstruction using colon interposition via a retrosternal route
Authors:Hitoshi Hino  Atsushi Shiozaki  Hitoshi Fujiwara  Shuhei Komatsu  Daisuke Ichikawa  Kazuma Okamoto  Yasutoshi Murayama  Yoshiaki Kuriu  Hisashi Ikoma  Masayoshi Nakanishi  Toshiya Ochiai  Yukihito Kokuba  Eigo Otsuji
Institution:1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto, 602-8566, Japan
Abstract:Currently, when the colon is used for reconstruction after esophagectomy, the supercharge technique is occasionally employed. At our institution, we perform esophagectomy using a procedure in which the laparoscopic transhiatal approach and digestive reconstruction precede the specimen resection. In addition, a retrosternal route is selected for reconstruction. We have devised an intrathoracic supercharge technique for this type of esophagectomy. Two patients whose stomachs were not available for reconstruction underwent subtotal esophagectomy with this supercharge technique. In these cases, the right-side colon was pulled up via a retrosternal route for reconstruction, and anastomoses were performed between the ileocolic artery and right internal thoracic artery, and between the ileocolic vein and superior vena cava, without microsurgery in the pleural space after removing the esophagus. This supercharge technique has the advantage of being less cumbersome, and we consider it to be suitable for esophageal reconstruction.
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