Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology head and neck surgery · 2014
[Laryngo-tracheal flap to reconstruct the defect after resection of the hypopharyngeal carcinoma with cervical esophagus involvement].
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Li Wen, Yang Liu, Chen Min, Zhu Jiao, Yuan Liqing, Gu Deying
Аннотация
OBJECTIVE: To investigate cervical esophageal reconstruction by means of laryngo-tracheal flap after resection of hypopharyngeal carcinoma with cervical esophageal involvement.
METHOD: Eleven cases of hypopharyngeal carcinoma with cervical esophageal involvement. Unilateral piriform sinus and cervical esophagus were involved in 8 cases (8/11) while bilateral piriform sinus, posterior pharyngeal wall and cervical esophagus were involved in 3 cases. After resection of laryngeal, pharyngeal and esophageal tumors and bilateral neck dissection, direct anastomosis of larynx and trachea with esophagus of cervico-thoracic segment was performed if circular structure of larynx and trachea could be preserved (3/11), pectoralis major myocutaneous flap was employed if only part of pharynx and larynx could be preserved (8/11). Postoperative radiochemotherapy was adopted and follow-up lasted for 1-5 years.
RESULT: All cases healed without event except for one case of pharyngeal fistula and one case of chylous fistula which also healed after about 2 weeks dressing change. All patients got normal diet without anastomotic stricture. There was no recurrence in 6 patients at the 3 years follow-up, 4 patients had metastases in the neck and 1 patient had thoracic esophageal carcinoma with hepatic metastasis arid gave up further treatment. The overall 3-year survival rate was 54.5%.
CONCLUSION: Using laryngo-tracheal flap to reconstruct cervical esophagus after resection of hypopharyngeal carcinoma with cervical esophageal involvement is a recommendable method that is simple in processing, reliable in effect and less in postoperative complications.
METHOD: Eleven cases of hypopharyngeal carcinoma with cervical esophageal involvement. Unilateral piriform sinus and cervical esophagus were involved in 8 cases (8/11) while bilateral piriform sinus, posterior pharyngeal wall and cervical esophagus were involved in 3 cases. After resection of laryngeal, pharyngeal and esophageal tumors and bilateral neck dissection, direct anastomosis of larynx and trachea with esophagus of cervico-thoracic segment was performed if circular structure of larynx and trachea could be preserved (3/11), pectoralis major myocutaneous flap was employed if only part of pharynx and larynx could be preserved (8/11). Postoperative radiochemotherapy was adopted and follow-up lasted for 1-5 years.
RESULT: All cases healed without event except for one case of pharyngeal fistula and one case of chylous fistula which also healed after about 2 weeks dressing change. All patients got normal diet without anastomotic stricture. There was no recurrence in 6 patients at the 3 years follow-up, 4 patients had metastases in the neck and 1 patient had thoracic esophageal carcinoma with hepatic metastasis arid gave up further treatment. The overall 3-year survival rate was 54.5%.
CONCLUSION: Using laryngo-tracheal flap to reconstruct cervical esophagus after resection of hypopharyngeal carcinoma with cervical esophageal involvement is a recommendable method that is simple in processing, reliable in effect and less in postoperative complications.