***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Background Esophagectomy through cervico-thoraco-abdominal approach is a useful surgical technique in treating patients with esophageal cancer . However , the cervical reconstruction is also known to have a high rate of anastomotic leakage , as well as anastomotic stricture , intrathoracic stomach syndrome , reflux esophagitis and other complications , thereby influencing postoperative recovery and quality of life . Aims The objective of this study was to investigate whether tubular stomach is superior to whole stomach in reducing anastomotic leakage for esophageal reconstruction through the cervico-thoraco-abdominal ( 3-field ) approach . Methods A total of 850 patients undergoing the 3-field esophagectomy  were retrospectively included in this study and divided into a tubular stomach reconstruction group ( Group A , n = 453 ) and a whole stomach reconstruction group ( Group B , n = 397 ) . All patients underwent esophagectomy through right thorax , left cervical part , abdominal triple incisions and done in esophageal reconstruction by h and -sewn two-layer anastomosis . Results Results revealed that in comparison with whole stomach , esophageal reconstruction with tubular stomach had a lower incidence of anastomotic leakage ( 5.5 vs. 9.3 % , P < 0.05 ) , less manifestation of intrathoracic syndrome ( 3.3 vs. 9.8 % , P < 0.001 ) and less occurence of reflux esophagitis ( 5.1 vs. 11.1 % , P < 0.01 ) . However , for the incidence of anastomotic stricture , there was no significant difference between the two groups ( 9.3 vs. 9.8 % ) . Conclusions This observation study suggests that for esophageal cancer patients undergoing the 3-field esophagectomy tubular stomach is better than whole stomach for esophageal reconstruction as reflected by a reduced postoperative anastomotic leakage , intrathoracic syndrome and reflux esophagitis Purpose The type of anastomosis and its outcome can affect postoperative morbidity , mortality , and quality of life after esophagectomy . We compared the outcomes of cervical h and -sewn anastomosis ( CHS ) and intrathoracic stapled anastomosis ( ITS ) performed after esophagectomy and gastric reconstruction . Methods Thirty-two patients with middle or lower thoracic esophageal cancer were prospect ively r and omized to undergo CHS ( n = 18 ) or ITS ( n = 14 ) after esophagectomy .  We compared clinical data , postoperative symptoms , and long-term survival in the two groups . Results The rates of anastomotic leak and stricture in the CHS and ITS groups were 16.7 % versus 7.1 % and 0 % versus 14.2 % , respectively , which do not represent significant differences . The respective rates of recurrent laryngeal nerve palsy were 38.8 % versus 7.1 % ( P < 0.05 ) , and proximal esophageal resection was 15 mm longer ( P < 0.05 ) in the CHS group . There were no significant differences in symptoms 6 months after surgery , or in the overall 5-year survival rates ( 72.2 % and 85.7 % , respectively ) . Conclusions The two methods of anastomosis yielded similar anastomotic outcomes . Although the incidence of recurrent laryngeal nerve injury was higher after CHS , and proximal esophageal resection was longer , this had little impact on postoperative symptoms and long-term survival By radioisotope technique , we studied the emptying function of the  vagotomized intrathoracic stomach after esophagectomy for carcinoma of the esophagus in 24 patients , and compared it with the preoperative emptying function . The patients were r and omized into a control group  ( no pyloroplasty )  and a study group ( pyloroplasty )  . Gastric emptying was delayed in both groups , postoperatively ; however , the delay was greater in the control group than in the study group . Therefore , vagotomy delays the emptying of the thoracic stomach , and this delay is not completely corrected by pyloroplasty OBJECTIVE For patients undergoing oncologic surgery , the quality of life ( QoL ) is generally accepted as an important outcome parameter in addition to long-term survival , mortality and complication rates . This study focussed on the QoL in patients after oesophagectomy for cancer , comparing the method of reconstruction ( narrow gastric tube vs whole stomach ) . METHODS In a prospect i ve r and omised single-centre study from 2007 to 2008 , 104 patients underwent oesophagectomy for cancer . To assess the QoL , a question naire in reference to the EORTC-QLQ-C30 and the QLQ-OES24 was administered at 3 weeks , 6 months and 1 year after surgery . Clinical data were collected prospect ively , and follow-up was performed regularly . RESULTS There were no significant differences between the narrow gastric tube group ( NGT group , n=52 ) and the whole-stomach group ( WS group , n=52 ) with regard to patient and cancer characteristics , operative procedure , postoperative intensive care unit ( ICU ) hospitalisation , and overall survival at 1 year . Regarding the postoperative complication , there were more cases of postoperative reflux oesophagitis and impairment of pulmonary function in the WS group ( P<0.05 ) . Regarding the QoL investigation , the scores of QoL dropped for all patients at 3 weeks after surgery . Slowly , recovery was found at both 6 months and 1 year in both groups . Patients in the NGT group reported significantly ( P<0.05 ) better scores of QoL at both 6 months and 1 year . CONCLUSIONS Patients who underwent gastric tube reconstruction  develop less postoperative digestive tract complications , and have a quicker recovery and a better QoL during the follow-up period . Further investigation and data collection will allow the assessment of this procedure beyond 1 year after operation AIM To assess the influence of the route of conduit transposition after  transhiatal oesophagectomy  on the postoperative morbidity and mortality and late outcome at 6 months . METHODS Patients with oesophageal carcinoma , undergoing transhiatal oesophagectomy ( gastric conduit ) , were r and omized to either anterior or posterior route of conduit transposition . Patients with advanced tumour , distant metastasis , extensive invasion of the stomach , previous gastric surgery , any anterior mediastinal abnormality detected on preoperative imaging , ASA grade III/IV and poor preoperative pulmonary function were excluded .  Intraoperative complications , postoperative morbidity and mortality and late outcomes were compared . RESULTS Of the 49 patients ( 34 men ) , 24 patients were r and omized to the anterior mediastinal route and 25 to the posterior . The mean duration of the operative procedure ( anterior : 235min ; posterior : 225min ) and the mean blood loss ( anterior : 531ml ; posterior : 538ml ) were not statistically different . The most common complications were pulmonary and cardiac and comparable in both groups . Four patients died postoperatively . At 6-month follow-up the incidence of dysphagia , anastomotic stricture , anastomotic recurrence , aspiration and reflux symptoms and weight gain were similar . CONCLUSIONS The route of conduit transposition did not affect the outcome . However , an individualized approach depending upon the operative findings , radicality of the procedure , and perceived need for postoperative adjuvant therapy may be useful Background For patients undergoing oncologic surgery  , the quality of life ( QoL ) is generally accepted as an important outcome parameter in addition to long-term survival , mortality , and complication rates . Our study focused on outcome in terms of QoL in patients with esophageal cancer , comparing the sites of anastomosis ( cervical versus thoracic anastomosis ) . Methods In a prospect i ve longitudinal single-center study from 1998 to 2005 , 105 patients underwent surgery for esophageal cancer . To assess QoL the EORTC-QLQ-C-30 and a tumor-specific module were administered before surgery , at discharge , and three , six , 12 , and 24 months after surgery . Clinical data were collected prospect ively and follow-up was performed every six months . Results The histological type was squamous cell carcinoma in 51.4 % of the cases , adenocarcinoma in 41.9 % , and some other type in 6.7 % . There was no significant difference between cervical and thoracic anastomosis with regard to morbidity , mortality , and survival rates ( 30 % five-year survival rate ) , whereas tumor stage was a significant ( p < 0.001 ) prognostic factor . Most QoL scores dropped significantly below baseline in the early postoperative period . Even though they recovered slowly during the follow-up period , they never reached preoperative levels again . There was no statistically significant difference in any of the QoL scales between patients with a cervical or a thoracic anastomosis . Conclusions Esophageal resections are associated with significant deterioration of QoL , which persists during the follow-up period . The surgical technique and position of the esophagogastrostomy did not affect QoL deterioration BACKGROUND We evaluated the impact of the size of gastric tubes on tissue blood flow of the anastomotic site , the frequency of leakage and the postoperative nutritional status . METHODS Forty-four patients were r and omly allocated to either reconstruction using subtotal stomach ( n = 22 ) or to reconstruction using slender gastric tube ( n = 22 ) after esophagectomy .  The tissue blood flow at the anastomotic site was measured . The postoperative nutritional status of 17 patients without recurrence was examined . Possible correlations between the type of esophageal substitute and the tendency to leakage as well as postoperative nutritional status were examined . RESULTS There was no significant difference in the tissue blood and the frequency of leakage between the types of gastric tubes . There was no significant difference noted between the two in the postoperative nutritional status at 6 and 12 months after operation . CONCLUSIONS The width of gastric tube has no impact on tissue blood flow , the frequency of leakage , and the postoperative nutritional status after esophagectomy BACKGROUND The optimal management of the pylorus during  esophagogastrectomy  is unknown . Pyloromyotomy and pyloroplasty cause early edema and risk long-term bile reflux ; however , the lack of pyloric drainage might risk early aspiration . METHODS We performed a retrospective study with a prospect i ve data base on patients with esophageal cancer or high- grade dysplasia who underwent Ivor-Lewis esophagogastrectomy . All had one surgeon and similar stomach tubularization , h and -sewn anastomoses , nasogastric tube duration , and postoperative prokinetic agents .  Outcomes of postoperative gastric emptying , aspiration , and swallowing symptoms were compared . RESULTS Between January 1997 and June 2008 , there were 221 patients . Seventy-one patients had a pyloromyotomy  , and gastric emptying judged on postoperative day 4 was delayed in 93 % ( 52 % had any morbidity and 14 % had respiratory morbidity ) . Fifty-four patients had no drainage procedure , and gastric emptying was delayed in 96 % ( 59 % had any morbidity and 22 % had respiratory morbidity ) . Twenty-eight patients underwent pyloroplasty , and 96 % had delayed gastric emptying ( 50 % had any morbidity and 32 % had respiratory morbidity ) . Sixty-eight patients had botulinum toxin injection into the pylorus . Gastric emptying was delayed in only 59 % ( P = .002 , 44 % had any morbidity and 13 % had respiratory morbidity ) . Hospital length of stay ( P = .015 ) and operative times ( P = .037 ) were shorter in the botulinum toxin group . Follow-up ( mean , 40 months ) showed symptoms of biliary reflux to be lowest in the botulinum toxin group ( P = .024 ) . CONCLUSION Injection of the pylorus with botulinum toxin at the time of esophagogastrectomy is safe and decreases operative time when compared with pyloroplasty or pyloromyotomy . In addition , it can improve early gastric emptying , decrease respiratory complications , shorten hospital stay , and reduce late bile reflux . A prospect i ve multi-institutional r and omized trial is needed Objective A prospect i ve r and omized trial was performed to compare retrosternal and posterior mediastinal gastric tube reconstruction with regard to postoperative function and quality of life . Methods Twenty-six patients were r and omly allocated to either retrosternal ( n = 14 ) or posterior mediastinal ( n = 12 ) reconstruction after gastric tube formation . Radionuclide transit studies were applied to obtain objective functional data and a st and ardized quality -of-life assessment was performed . Results Retrosternal reconstruction showed an increased morbidity ( 15 vs 13 major complications ) and mortality ( 14.2 vs 8.3 % ) . Radionuclide clearance 
    Output:
    
Most studies showed superior passage of the gastric tube compared with the whole stomach .
Pyloric drainage is not significantly associated with the risk of developing delayed gastric emptying after esophagectomy .