Abstract
The main objective of this retrospective analysis was to understand the length of stay in hospital, the complication rates and the perioperative mortality after various forms of hypopharyngeal reconstructions. This is a retrospective analysis of hypopharyngeal cancer patients who underwent surgery at the Tata Memorial Hospital, during 2005–2010. Of the total 393 patients, 103 required some form of pharyngeal reconstruction. The mean age of this population was 56 with a male to female ratio of 4:1. The mean hospital stay for all patients was 22 days (mean: 22, median: 15) and 17 % were readmitted for various reasons in the first 30 days after the initial discharge from hospital. The overall perioperative mortality was 10 % (10/103) and majority of these patients (6/10) had GPU as part of treatment. Gastric pull up has a high morbidity especially in patients with low albumin levels and should be used judiciously when needed. A comprehensive analysis of clinical and radiological data is helpful for choosing an ideal reconstruction after hypopharyngeal cancer excision.
Abbreviations
- U_PFS:
-
Unilateral pyriform sinus
- B_PFS:
-
Bilateral pyriform sinus
- LPW:
-
Lateral pharyngeal wall
- PPW:
-
Posterior pharyngeal wall
- PMMC:
-
Pectoralis major myocutaneous flaps
- FRAFF:
-
Free radial forearm flap
- JEJUNUM:
-
Free jejunum
- GPU:
-
Gastric pull-up
- DL:
-
Direct laryngoscopy
References
Couch ME (2002) Laryngopharyngectomy with reconstruction. Otolaryngol Clin North Am 35:1097–1114
Silver CE, Ferlito A (1996) Surgery for cancer of the larynx and related structures, 2nd edn. W B Saunders Co, Philadelphia
Gupta T, Chopra S, Agarwal JP, Laskar S-G, D’cruz AK, Shrivastava SK et al (2009) Squamous cell carcinoma of the hypopharynx: single-institution outcome analysis of a large cohort of patients treated with primary non-surgical approaches. Acta Oncol 48:541–548
Ferrer Ramírez MJ, Guallart Doménech F, Brotons Durban S, Carrasco Llatas M, Estellés Ferriol E, López Martínez R (2004) Hypopharyngeal cancer: analysis of the evolution and surgical results. Acta Otorrinolaringol Esp 55:67–72
Chang MF, Wang HM, Kang CJ, Huang SF, Lin CY, Fang KH et al (2010) Treatment results for hypopharyngeal cancer by different treatment strategies and its secondary primary-an experience in Taiwan. Radiat Oncol 5:91
Hamoir M, Machiels J-P, Schmitz S, Gregoire V (2011) Multidisciplinary management of hypopharyngeal carcinoma. In: Bernier J (ed) Head and neck cancer. Springer, New York, pp 431–55http://www.springerlink.com/content/t75286857t36749q/abstract/
Spector JG, Sessions DG, Emami B, Simpson J, Haughey B, Harvey J et al (1995) Squamous cell carcinoma of the pyriform sinus: a nonrandomized comparison of therapeutic modalities and long-term results. Laryngoscope 105:397–406
Johansen LV, Grau C, Overgaard J (2000) Hypopharyngeal squamous cell carcinoma: treatment results in 138 consecutively admitted patients. Acta Oncol 39:529–536
Hiroto I, Nomura Y, Sueyoshi K, Mitsuhashi S, Ichikawa A (1969) Pathological studies relating to neoplasms of the hypopharynx and the cervical esophagus. Kurume Med J 16:127–133
Davidge-Pitts KJ, Mannel A (1983) Pharyngolaryngectomy with extrathoracic esophagectomy. Head Neck Surg 6:571–574
Chopra S, Gupta T, Agarwal J, Ghosh Laskar S, Budrukkar A, Murthy V et al (2009) Postoperative adjuvant radiotherapy for hypopharyngeal cancers: outcome analysis of 159 patients. Int J Radiat Oncol Biol Phys 75:S393
Theile DE, Robinson DW, McCafferty GJ (1986) Pharyngolaryngectomy reconstruction by revascularized free jejunal graft. Aust N Z J Surg 56:849–852
Coleman JJ 3rd, Searles JM Jr, Hester TR, Nahai F, Zubowicz V, McConnel FM et al (1987) Ten years experience with the free jejunal autograft. Am J Surg 154:394–398
Sullivan MW, Talamonti MS, Sithanandam K, Joob AW, Pelzer HJ, Joehl RJ (1999) Results of gastric interposition for reconstruction of the pharyngoesophagus. Surgery 126:666–671 Discussion 671–672
Ujiki GT, Pearl GJ, Poticha S, Sisson GA Sr, Shields TW (1987) Mortality and morbidity of gastric “pull-up” for replacement of the pharyngoesophagus. Arch Surg 122:644–647
Reinhardt GF, Myscofski JW, Wilkens DB, Dobrin PB, Mangan JE Jr, Stannard RT (1980) Incidence and mortality of hypoalbuminemic patients in hospitalized veterans. J Parenter Enteral Nutr 4:357–359
Herrmann FR, Safran C, Levkoff SE, Minaker KL (1992) Serum Albumin Level on Admission as a Predictor of Death, Length of Stay, and Readmission. Arch Intern Med 152:125–130
Mullen JL, Gertner MH, Buzby GP, Goodhart GL, Rosato EF (1979) Implications of malnutrition in the surgical patient. Arch Surg 114:121–125
Benazzo M, Bertino G, Occhini A, Spasiano R, Gatti P (2006) Functional outcomes in patients reconstructed with flaps following surgery for hypopharyngeal cancer. Acta Otorhinolaryngol Ital 26:127–132
Clark J, Gilbert R, Irish J, Brown D, Neligan P, Gullane P (2006) Morbidity after flap reconstruction of hypopharyngeal defects. Laryngoscope 116:173–181
Disa JJ, Pusic AL, Hidalgo DA, Cordeiro PG (2003) Microvascular reconstruction of the hypopharynx: defect classification, treatment algorithm, and functional outcome based on 165 consecutive cases. Plast Reconstr Surg 111:652–660
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Joshi, P., Nair, S., Chaturvedi, P. et al. Hypopharyngeal Cancers Requiring Reconstruction: A Single Institute Experience. Indian J Otolaryngol Head Neck Surg 65 (Suppl 1), 135–139 (2013). https://doi.org/10.1007/s12070-013-0627-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12070-013-0627-9