Gastric conduit staple line after esophagectomy: To oversew or not?

Abstract

contralateral pleura make necessary a clinical study. We showed the feasibiliy of VAM dissection in resecting the paratracheal mesothelial cysts. Our cases showed the interest of using VAM for left-sided BPF. The dissection of the trachea through its natural route enables tracheal mobilization. The mediastinal shift is not a contraindication for VAM but represents a risk for contralateral pleural opening during transpericardial sternotomy or the modified Abruzzini technique. Previous mediastinoscopy is not a contraindication inasmuch as the morbidity is not increased and there is a low risk of contamination. Our 2 cases showed good technical results. The first patient is still alive 2 years after the procedure. Unfortunately, the second patient died of severe sepsis. Perhaps all types of surgery in the presence of severe sepsis are risky. In conclusion, each patient must be treated individually. The best method of closure must be based on the unique set of circumstances. Direct surgical repair can be achieved in most patients. The VAM technique is our choice for a long (at least 10 mm) bronchial stump on the left side because its specific morbidity is minimal compared with transpericardial sternotomy or a transthoracic approach.