Fig 1.
(a) Reference points for measuring the length of the esophagus and stomach and the posterior mediastinal route. ① Cricoid cartilage, ② jugular notch, ③ tracheal bifurcation, ④ middle point between ③ and ⑤, ⑤ esophageal hiatus, and ⑥ gastroduodenal artery. (b) Reference points for measuring the length of the retrosternal route. ① Cricoid cartilage, ② jugular notch, ③ tracheal bifurcation, ④ lower border of the body of sternum, ⑤ lower border of the left hepatic lobe, and ⑥ gastroduodenal artery.
Fig 2.
Measurement methods for factors contributing to the length of the reconstruction route.
(a) Thin thorax: BMI of 17.9 kg/m2, thoracic thickness of 9.7 cm, and RS–ES length of -0.7 cm. (b) Thick thorax: BMI of 26.3 kg/m2, thoracic thickness of 14.3 cm, and RS–ES length of 1.8 cm. Each point was measured in the mid-sagittal central plane. ① The thickness of the thorax was measured from the lower border of the body of the sternum to the vertebral body. ② The height of the thorax was measured from the upper border of the jugular notch to the lower border of the body of the sternum. ③ The depth of the thoracic inlet space was measured from the upper border of the jugular notch to the lower border of the cricoid cartilage. ④ The thoracic curve was measured at the angle of the extended intersection between Th1 upper and Th12 lower borders of the vertebral body. ⑤ The height of the liver was measured at the cranial–caudal distance. ⑥ The thickness of the liver was measured at the anterior–posterior distance.
Table 1.
Characteristics of each reconstruction route group.
Table 2.
Length of each route and difference between post- and preoperative lengths.
Fig 3.
Relationships between the three factors and differences in reconstruction lengths.
The three factors associated with the difference between the length of the retrosternal route and that of the esophagus–stomach (RS–ES) were analyzed using Spearman’s rank correlation coefficient; positive correlations were observed with each factor. (a) Body weight: ρ = 0.42, p = 0.007; (b) BMI: ρ = 0.52, p = 0.001; (c) Thickness of the thorax: ρ = 0.39, p = 0.01.
Table 3.
Relationship between factors and reconstruction routes.
Table 4.
Studies on the differences between RSa and PMb.