Significance of the use of a laryngotracheal flap to reconstruct defects and manage pharyngoesophageal stenosis after the resection of hypopharyngeal carcinoma with cervical oesophagus involvement: a retrospective study.

BACKGROUND

The main objective of this study was to investigate cervical oesophageal reconstruction by a laryngotracheal flap (LTF) and the management of postoperative pharyngoesophageal stenosis (PES) after the resection of hypopharyngeal carcinoma with cervical oesophageal involvement.

METHODS

The retrospective cohort study of fourteen patients with hypopharyngeal carcinoma exhibiting cervical oesophageal involvement were included in the study from January 2012 to January 2021. Postoperative radiochemotherapy was utilised, and follow-up occurred for 3-5 years. The Kaplan-Meier method was used for survival analysis.

RESULTS

All of the patients demonstrated healing without events, except for one patient who experienced a pharyngocutaneous fistula, which also healed after approximately 2 weeks of dressing changes. With a follow-up of 3-5 years, the median duration of follow-up was 49 months (range = 36-60 months). Eight patients died during follow-up. Moreover, three patients had metastases in the neck, 1 patient had metastases in the lung, and 1 patient discontinued further treatment because of thoracic oesophageal carcinoma with hepatic metastasis. The 5-year overall survival was 42.9%. Among the 14 included patients, two patients developed pharyngoesophageal stenosis, and the remaining patients recovered well. Two patients with pharyngoesophageal stenosis causing feeding difficulties received nasogastric tube nasal feeding and urinary catheter dilation after the scar tissue was removed via coblator plasma surgery at the stenosis and were fed via nasogastric tube for 1-3 months.

CONCLUSION

As an effective repair method, laryngotracheal flaps have broad application prospects in the repair of the cervical oesophagus after the resection of hypopharyngeal carcinoma with cervical oesophageal involvement. Coblator plasma surgery and catheter dilation may effectively address the problem of eating difficulties in patients with postoperative pharyngoesophageal stenosis.