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Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer

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Abstract

Background and study aims

Narrow band imaging (NBI) combined with magnifying endoscopy enables us to detect superficial laryngo-pharyngeal cancers, which are difficult to detect by standard endoscopy. Endoscopic laryngo-pharyngeal surgery (ELPS) is a technique developed to treat such lesions and the purpose of this study is to evaluate the usefulness of ELPS for superficial laryngo-pharyngeal cancer.

Patients and methods

Seventy five consecutive patients with 104 fresh superficial laryngo-pharyngeal cancers are included in this study. Under general anesthesia, a specially-designed curved laryngoscope was inserted to create a working space in the pharyngeal lumen. A magnifying endoscope was inserted transorally to visualize the field and a head & neck surgeon dissected the lesion using the combination of the orally-inserted curved grasping forceps and electrosurgical needle knife in both hands. The safely, functional outcomes, and oncologic outcomes of ELPS were evaluated retrospectively.

Results

Median operation time per lesion was 35 min. Post-operative bleeding occurred in 3 cases and temporal subcutaneous emphysema occurred in 10 cases. No vocal fold impairment occurred after surgery. The median fasting period was 2 days and all patients except one have a normal diet with no limitations. Local recurrence occurred in 1 case, and the 3-year overall survival rate and the 3-year disease specific survival rate was 90 % and 100 %, respectively.

Conclusions

ELPS is a hybrid of head and neck surgery and gastrointestinal endoscopic treatment, and enjoys the merit of both procedures. ELPS makes it possible to perform minimally-invasive surgery, preserving both the swallowing and phonation functions.

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Acknowledgments

This study was supported in part by Grants-in-aid for research from the Ministry of Health, Labor, and Welfare of Japan and the Ministry of Education, Culture, Sports, Science, and Technology of Japan. The authors disclose no financial relationship relevant to this publication.

Disclosures

Ichiro Tateya, Manabu Muto, Shuko Morita, Shin’ichi Miyamoto, Tomomasa Hayashi, Makiko Funakoshi, Ikuo Aoyama, Hirokazu Higuchi, Shigeru Hirano, Morimasa Kitamura, Seiji Ishikawa, Yo Kishimoto, Mami Morita, Juichi Ito have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, Graduate of Medicine, Kyoto University, Sakyo-ku, Kyoto, 606-8507, Japan

    Ichiro Tateya, Shigeru Hirano, Morimasa Kitamura, Seiji Ishikawa, Yo Kishimoto, Mami Morita & Juichi Ito

  2. Department of Clinical Oncology, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Manabu Muto, Tomomasa Hayashi, Makiko Funakoshi & Ikuo Aoyama

  3. Department of Gastroenterology and Hepatology, Graduate of Medicine, Kyoto University, Kyoto, Japan

    Shuko Morita & Shin’ichi Miyamoto

  4. Department of Medical Supply, Kyoto University Hospital, Kyoto, Japan

    Hirokazu Higuchi

Authors
  1. Ichiro Tateya
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  2. Manabu Muto
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  3. Shuko Morita
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  11. Seiji Ishikawa
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  12. Yo Kishimoto
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  13. Mami Morita
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  14. Juichi Ito
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Corresponding author

Correspondence to Ichiro Tateya.

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Tateya, I., Muto, M., Morita, S. et al. Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer. Surg Endosc 30, 323–329 (2016). https://doi.org/10.1007/s00464-015-4213-y

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  • DOI: https://doi.org/10.1007/s00464-015-4213-y

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