Background Factors Associated with Postoperative Complications in Patients with Advanced Hypopharyngeal Cancers Undergoing Total Pharyngolaryngoesophagectomy Followed by Free Jejunal Flap Reconstruction

Abstract

We retrospectively analyzed background factors associated with postoperative complications in patients with advanced hypopharyngeal cancers who underwent total pharyngolaryngectomy followed by free jejunal flap reconstruction. A total of 23 participants, including 21 men and 2 women aged 49 to 83 years (average 72.3 years) were enrolled in this study. Mild and moderate/severe complications occurred in five and seven cases, respectively. The most common complication was stricture of the esophagojejunal anastomosis (nine cases). Other complications included two tracheostomal stenosis, one each for pneumonia and chyle leakage. The free jejunal flap survived in all cases. The disease-free survival rate was 47.8% at 52 weeks after surgery. The platelet count was significantly lower (18.8 ± 1.9 × 104/mL vs. 27.7 ± 1.8 × 104/mL; p = 0.008) in patients with moderate/severe complications than in those without. The percentage of stage IV cases and intraoperative blood loss tended to be higher in patients with complications than in those without. Knowledge of these potential risk factors for the development of postoperative complications to satisfactorily manage the clinical course of patients with advanced hypopharyngeal cancers is necessary.