Total Pharyngolaryngoesophagectomy for Hypopharyngeal, Laryngeal, and Cervical Esophageal Carcinoma
Eighteen cases, 11 male 7 female, with esophagus superior end, hypopharynx and invasive larynx carcinoma were operated between 1990– 1992. Median age was 49 years. Localization of the tumors were 16 cases at esophageal superior end and hypopharynx, 2 cases at larynx. Lesion located at between 14 and 19 cm from upper teeth arcus. While transhiatal approach was used in ten patients, thoracotomy and laparatomy and cervical approach in 8 patients. Bilateral cervical lymph dissection was performed in 12 patients. A mediastinal lymph dissection added to bilateral cervical dissection in 8 (44.4 %) patients. Gastric transposition was used for reconstruction in 17 patients. Oropharyngokologastrostomy was performed for one patient who previously underwent intrathoracic anastomosis. All of the patients had epidermoid cell carcinoma. Minimal anastomotic leakage devoloped in 4 (22.2 %) patients which healed spontaneously. The cause of perioperative mortality was postoperative mediastinitis in the first case, cerebral infarct in the second case and myocardial infarction was in the third case. Two patients died because of tumor recurrence 3 and 6 months after the operation. We have not detected any recurrence or metastasis of the tumor in the surviving group although our longest fallow up period 28 months.
Key WordsPharyngolaryngoesophagectomy gastric reconstruction
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- 1.Bains S M, Spiro R H (1979) Pharyngolaryngectomy, total extrathoracic esophagectomy and gastric transposition. Gyn & Obst 149:693.Google Scholar
- 4.Biel M, Maisel R H (1987) Free jejunal outograft reconstruction of the pharyngoesophagus: Review of a 10-year experience. Otolaryngo Head Neck Surg 97:369.Google Scholar