Impact of gastric tube diameter on upper mediastinal anatomy after transhiatal esophagectomy

The most common means of reconstructing the esophagus in patients undergoin g transhiatal esophagectomy is by passing the stomach through the esophagea l bed into the neck, where an esophagogastric anastomosis is fashioned. A n umber of factors need to be considered in mobilizing the stomach for transh iatal esophageal reconstruction: the stomach tube must have adequate blood supply and be wide enough to permit passage of solid food and yet narrow en ough to facilitate emptying and to fit through the limited space of the upp er mediastinum. The construction of a non-reversed, greater curvature gastr ic tube of approximately 4-5 cm diameter, supplied by the right gastroepipl oic vessels, appears to accomplish all of these goals.