Zhonghua wai ke za zhi [Chinese journal of surgery] · 1998
[Surgical treatment of the hypopharyngeal and cervical esophageal carcinoma].
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Jiang Y, Wang R, Fan S, Xiang J, Wu X, Zhao Y
Аннотация
OBJECTIVE: To review the experience of surgical treatment of hypopharyngeal and cervical esophageal carcinoma.
METHOD: Seventy-six patients with squamous-cell carcinoma of the hypopharynx and cervical esophagus underwent surgery in our department from 1980 to June 1997. The site of the tumour was in hypopharynx in 31 patients and in cervical esophagus in 45.
RESULT: The resectability rate of hypopharyngeal carcinoma (HPC) was 98.6% (30/31). The types of the esophageal reconstruction included pharyngo-esophageal anastomosis (3 patients) platysmamyocutaneous flaps reconstruction (PMFR) (12) free jejunal interposition (3) and gastric tube transposition following total pharyngolaryngo esophagectomy (12). The resectability rate of cervical esophageal carcinoma (CEC) was 91% (41/45). The esophageal construction applied gastric tube after esophagectomy without thoracotomy except one. The postoperative morbidity was 36.5% for gastric tube reconstruction (including one died of heart failure), 33.3% (1/3) for free jejunal interposition and zero for PMFR. The overall follow-up was from 2 to 108 months (median: 56.5 months) and the 1-, 3-, 5-year survival rates were 79.3%, 60% and 31.6% respectively for HPC and 68.3%, 9.5%, 0% respectively for CEC.
CONCLUSION: Our data demonstrated that the resectability rate of the HPC and CEC was quite high but the long-term result of HPC was better than that of CEC. The PMFR after pharyngolaryngo-cervicalesophagectomy was a safe, effective operation with low morbidity and excellent long-term results.
METHOD: Seventy-six patients with squamous-cell carcinoma of the hypopharynx and cervical esophagus underwent surgery in our department from 1980 to June 1997. The site of the tumour was in hypopharynx in 31 patients and in cervical esophagus in 45.
RESULT: The resectability rate of hypopharyngeal carcinoma (HPC) was 98.6% (30/31). The types of the esophageal reconstruction included pharyngo-esophageal anastomosis (3 patients) platysmamyocutaneous flaps reconstruction (PMFR) (12) free jejunal interposition (3) and gastric tube transposition following total pharyngolaryngo esophagectomy (12). The resectability rate of cervical esophageal carcinoma (CEC) was 91% (41/45). The esophageal construction applied gastric tube after esophagectomy without thoracotomy except one. The postoperative morbidity was 36.5% for gastric tube reconstruction (including one died of heart failure), 33.3% (1/3) for free jejunal interposition and zero for PMFR. The overall follow-up was from 2 to 108 months (median: 56.5 months) and the 1-, 3-, 5-year survival rates were 79.3%, 60% and 31.6% respectively for HPC and 68.3%, 9.5%, 0% respectively for CEC.
CONCLUSION: Our data demonstrated that the resectability rate of the HPC and CEC was quite high but the long-term result of HPC was better than that of CEC. The PMFR after pharyngolaryngo-cervicalesophagectomy was a safe, effective operation with low morbidity and excellent long-term results.