Reconstruction Using Stomach after Resection of Hypopharynx and Esophagus.
- Author:
Byung Seo JUNG
1
;
Jong Kwan KIM
;
Eun Chang CHOI
;
Choong Bai KIM
Author Information
1. Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea. cbkimmd@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Head and neck cancer;
Transhiatal esophagectomy;
Reconstruction;
Stomach
- MeSH:
Enteral Nutrition;
Esophageal Neoplasms;
Esophagectomy;
Esophagus*;
Head and Neck Neoplasms;
Humans;
Hypopharyngeal Neoplasms;
Hypopharynx*;
Jejunostomy;
Larynx;
Mortality;
Nutritional Support;
Otolaryngology;
Outcome Assessment (Health Care);
Parenteral Nutrition, Total;
Retrospective Studies;
Stomach*;
Survival Rate;
Thyroid Neoplasms;
Trachea
- From:Journal of the Korean Surgical Society
2001;61(4):387-392
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study sought to evaluate the treatment modality, morbidity and mortality after surgery, the method of nutritional support and the survival rate for patients with cancer of the hypopharynx, larynx and cervical esophagus. METHODS: A retrospective review was undertaken of 17 hypopharyngeal, laryngeal and cervical esophageal carcinoma patients who had undergone surgical treatment in the Department of Surgery and Otorhinolaryngology, Yonsei University, College of Medicine, from January 1995 to April 2000. All patients underwent transhiatal esophagectomy in order to avoid pulmonary complications. Outcome measures were calculated using the Kaplan-Meier estimator. RESULTS: The 17 consecutive patients included 11 cases of hypopharyngeal cancer, 3 glottic cancers, 2 cervical esophageal cancers and one thyroid cancer with invasion of the trachea and esophagus. Fifteen patients (88%) presented with an advanced tumor stage. As for nutritional support following surgery, 12 underwent feeding jejunostomy, 4 a nasoenteric tube feeding and the other recieved total parenteral nutrition. Nine patients (53%) developed complications following surgery. One of the patients who had surgery died postoperatively. The mean survival time was 26 months and the 2-year and 4-year overall survival rates were 69.5% and 53.0%, respectively. CONCLUSION: Reconstruction of the hypopharynx and esophagus using stomach was low mortality and low severe morbidity. A total pharyngolaryngoesophagectomy with gastric transposition and primary hypopharyngogastric anastomosis offers the best chance for cure or palliation with acceptable morbidity and degree of function for selected patients with advanced hypopharyngeal, laryngeal and cervical esophageal carcinomas.
