Retrosternal Reconstruction Can be a Risk Factor for Upper Extremity Deep Vein Thrombosis After Esophagectomy
Upper extremity deep vein thrombosis (UEDVT) is a rare but important complication because it can cause pulmonary embolism. The aim of this study was to investigate the incidence of UEDVT after esophagectomy and the risk factors related to UEDVT.
This study included 88 patients who underwent esophagectomy with retrosternal or posterior mediastinal reconstruction using gastric tube. The incidence of UEDVT and the diameter of left brachiocephalic vein were measured using postoperative contrast-enhanced computed tomography (CT). (a) The distance from sternum to brachiocephalic artery and (b) the distance from sternum to vertebra were measured by preoperative CT, and the ratio of (a) to (b) was defined as the width of the retrosternal space.
Among the patients, 14 (15.9%) suffered from UEDVT. All UEDVTs were found in left-side upper extremity deep veins. Twelve of the 14 patients (85.7%) underwent retrosternal reconstruction. In a multivariate analysis, retrosternal reconstruction was an independent risk factor for UEDVT (odds ratio 5.48). The diameter of the left brachiocephalic vein in patients with retrosternal reconstruction was significantly smaller than that in patients with posterior mediastinal reconstruction (4.3 vs 6.9 mm; P < 0.001) due to compression of left brachiocephalic vein by the gastric tube. Among patients with retrosternal reconstruction, the width of the retrosternal space in patients with UEDVT was significantly smaller than that in patients without UEDVT (0.21 vs 0.27; P = 0.001).
Retrosternal reconstruction can be a risk factor for UEDVT. In patients with small width of the retrosternal space, retrosternal reconstruction might be inappropriate.
Publisher URL: https://link.springer.com/article/10.1007/s00268-017-4120-6
Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.
Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.