胸骨后重建具有较低的术后严重并发症风险，例如胃-气管瘘或食管裂孔疝。我们先前报道了腹腔镜胸骨后路创建（LRRC）方法，但其安全性和有效性仍不清楚。我们回顾性地审查了2010年至2021年间接受姑息性McKeown食管切除术的374名食管癌患者。我们通过简单的最近邻法和无卡尺进行倾向性评分匹配分析，比较接受LRRC和接受后纵隔重建的患者的术后结果和重建的胃引流道功能。匹配后，有62名患者被纳入到腹腔镜胸骨后组（LR组）或后纵隔组（PM组）。两组之间除机器人辅助手术数量、淋巴结清扫范围和颈部吻合方式外，未观察到显著差异。Clavien-Dindo分级≥2并发症的发生率无显著差异。PM组发生胃气管瘘（n=1）和食管裂孔疝（n=2），LR组未出现。两组的肺栓塞发生率相似（5% vs. 5%）。术后吻合口狭窄率类似（16% vs. 27%，p=0.192）。术后1年内的内窥镜反流性食管炎（改良Los Angeles分类≥M）检查结果在LR组显著改善（p=0.037）。LRRC胃引流道重建具有安全和价值，与良好的重建胃引流道功能相关。©2023年。外科肿瘤学会。

Retrosternal reconstruction has lower risks for severe postoperative morbidities, such as gastro-tracheal fistula or esophageal hiatal hernia. We have previously reported the laparoscopic retrosternal route creation (LRRC) method, but its safety and efficacy remain unclear.In total, 374 patients with esophageal carcinoma who underwent minimally invasive McKeown esophagectomy in the prone position between 2010 and 2021 were retrospectively reviewed. We performed a propensity score-matched analysis with the simple, nearest-neighbor method and no calipers to compare postoperative outcomes and reconstructed gastric conduit functionality between patients who underwent LRRC and counterparts who underwent posterior mediastinal reconstruction.After matching, 62 patients were included in the laparoscopic retrosternal group (LR group) or posterior mediastinal group (PM group). No significant differences were observed between the groups, apart from the number of robot-assisted surgeries, the extent of lymph node dissection, and the method of cervical anastomosis. There were no significant differences in the incidence of Clavien-Dindo grade ≥ 2 complications. Gastro-tracheal fistula (n = 1) and esophageal hiatal hernia (n = 2) occurred in the PM group but not in the LR group. There were no differences in the incidence of pulmonary embolism between the groups (5% vs. 5%). The postoperative anastomotic stenosis rate was similar (16% vs. 27%, p = 0.192). Endoscopic findings of reflux esophagitis (modified Los Angeles classification ≥ M) at 1 year after surgery were significantly better in the LR group (p = 0.037).LRRC for gastric conduit reconstruction is safe and valuable. It is associated with good reconstructed gastric conduit function.© 2023. Society of Surgical Oncology.