Mungo B, Barbetta A, Lidor AO, Stem M, Molena D. Laparoscopic retrosternal gastric pull-up for fistulized mediastinal mass. World J Gastrointest Surg 2017; 9(3): 92-96 [PMID: 28396722 DOI: 10.4240/wjgs.v9.i3.92]
Corresponding Author of This Article
Daniela Molena, MD, Director of Esophageal Surgery, Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. molenad@mskcc.org
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Mar 27, 2017; 9(3): 92-96 Published online Mar 27, 2017. doi: 10.4240/wjgs.v9.i3.92
Laparoscopic retrosternal gastric pull-up for fistulized mediastinal mass
Benedetto Mungo, Arianna Barbetta, Anne O Lidor, Miloslawa Stem, Daniela Molena
Benedetto Mungo, Division of Thoracic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21218, United States
Arianna Barbetta, Daniela Molena, Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Anne O Lidor, Miloslawa Stem, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD 21218, United States
Author contributions: Molena D designed the study, surgically retrieved tumor, and followed up finding; Barbetta A, Lidor AO and Stem M researched literature and reviewed manuscript; Mungo B conducted literature review, collected data and drafted manuscript.
Institutional review board statement: This study was reviewed and approved by the Johns Hopkins Hospital Institution Review Board, ID # NA_00023795.
Informed consent statement: Retrospective study and no consent needed.
Conflict-of-interest statement: The authors declare there is no conflict of interest related to the publication of this case report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Daniela Molena, MD, Director of Esophageal Surgery, Thoracic Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, United States. molenad@mskcc.org
Telephone: +1-212-6393870 Fax: +1-646-2277106
Received: August 24, 2016 Peer-review started: August 26, 2016 First decision: September 27, 2016 Revised: November 12, 2016 Accepted: January 16, 2017 Article in press: January 18, 2017 Published online: March 27, 2017 Processing time: 211 Days and 12.8 Hours
Abstract
We describe the case of a patient successfully reconstructed with laparoscopic retrosternal gastric pull-up after esophagectomy for unresectable posterior mediastinal inflammatory myofibroblastic tumor, eroding into the esophagus and compressing the airways. A partial esophagectomy with esophagostomy was performed for treatment of esophageal pleural fistula and empyema, while the airways were managed with the placement of an endobronchial stent. Gastrointestinal reconstruction was performed using a laparoscopic approach to create a retrosternal tunnel for gastric conduit pull-up and cervical anastomosis. The patient was discharged uneventfully after 6 d, and has done very well at home with normal diet.
Core tip: Retrosternal gastric tube has been used in various clinical scenarios, for both malignant and benign esophageal disease. The laparoscopic approach allowed for a simple, fast, and controlled dissection of the retrosternal plain and reconstruction of the alimentary tract. This approach should be considered as a valid alternative for reconstruction of the alimentary tract in patients where the prevertebral route is not available.
