Complication following gastric pull-up reconstruction for advanced hypopharyngeal or cervical esophageal carcinoma: a 20-year review in a Chinese institute

Shuangba, He; Sun, Jingwu; Wang, Yinfeng; Hu, Yong-Fang; Lv, Qiuping; Xianguang, Li; Wang, Xu; Wang, Shengjun; Zhenkun, Yu

doi:10.1016/j.amjoto.2010.05.002

Cited by 43 publications

(39 citation statements)

References 15 publications

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“…In this study, no patient died during the early postoperative period, although one patient died at home 3 months after surgery due to an unknown cause. As for postoperative pulmonary infection after TLPE, it was previously reported to be 10-26% [5,6,10]. We found that 1 out of 10 patients (10%) in this study had pneumonia in the early postoperative period, although 9 out of 10 patients received mediastinal dissection simultaneously.…”

Section: Discussionsupporting

confidence: 44%

“…As for postoperative complications after TLPE with gastric pull-up reconstruction, the in-hospital mortality rate was previously reported to be 0-16% [4,5,6,10]. In this study, no patient died during the early postoperative period, although one patient died at home 3 months after surgery due to an unknown cause.…”

Section: Discussionmentioning

confidence: 51%

“…Early postoperative complications were reported in detail by Shuangba et al, who reported the outcomes for 208 patients after TLPE with gastric pull-up reconstruction [6]. With regard to early postoperative thoraco-abdominal complications, pneumonitis was observed in 23 (11.1%), pleural effusion in 15 (7.2%), chylous fistula in 4 (1.9%), heart failure in 4 (1.9%), hemoperitoneum in 2 (1%), and burst abdomen in 2 patients (1%).…”

Section: Discussionmentioning

confidence: 99%

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Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

Homma

Nakamaru

Hatakeyama

et al. 2014

Eur Arch Otorhinolaryngol

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Total laryngo-pharyngo-esophagectomy (TLPE) with gastric pull-up reconstruction is still considered to be associated with major complications and a significant risk of in-hospital death. Minimally invasive esophagectomy, avoiding thoracotomy and laparotomy, has been increasingly performed for esophageal malignancies with the hope of reducing mortality and morbidity, such as pulmonary complications. The aim in this study was to assess early and long-term morbidity as well as treatment outcomes in patients treated with TLPE with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision. From 2004 to 2013, 10 patients with a median age of 64 years (range 47-71 years) underwent minimally invasive TPLE with gastric pull-up reconstruction. Seven of the 10 patients had previously received radiotherapy. As for early postoperative complications, no patient died during the early postoperative period, and pneumonia was observed in 1, skin necrosis in 1, pseudomembranous enterocolitis in 1, arrhythmia in 2, hemorrhage in the neck in 2, anastomotic leakage in the neck in 3, and tracheal necrosis in 6 patients. Three patients developed tracheostomal stenosis as a long-term postoperative complication, and an anastomotic stricture was observed in one patient. All patients were able to achieve oral intake, but 3 patients required feeding tube support. In conclusion, postoperative systemic complications during the early postoperative period were considered to be acceptable, although wound complications such as tracheal necrosis and anastomotic leakage were commonly observed. Therefore, this minimally invasive procedure might help reduce mortality and morbidity in patients requiring TLPE with gastric pull-up reconstruction

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Section: Discussionsupporting

confidence: 44%

Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

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Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

Homma

Nakamaru

Hatakeyama

et al. 2014

Eur Arch Otorhinolaryngol

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“…Currently available surgical procedures for advanced hypopharyngeal carcinoma with cervical esophageal invasion include gastric pull-up, free jejunal flap transplantation and musculocutaneous flap [1][2][3][4]. Although all these techniques can provide a good pharyngoesophageal reconstruction, viscera transfer associated with higher rates of operative mortality and fistula formation, and the use of pectoralis major myocutaneous flap or free flap for tubular repair can also lead to anastomotic stricture [5].…”

Section: Introductionmentioning

confidence: 99%

Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus

Yin

Tang

Wang

et al. 2014

Eur Arch Otorhinolaryngol

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The aim of this study was to explore xenogeneic acellular dermal matrix (ADM) in combination with pectoralis major myocutaneous flap in hypopharynx and cervical esophagus reconstruction. A total of five patients were treated with this surgical method to reconstruct hypopharynx and cervical esophagus in Second Xiangya Hospital between January 2012 and April 2013. Four of them had hypopharyngeal carcinoma with laryngeal and cervical esophageal invasion, while the fifth patient with hypopharyngeal cancer had developed scars and atresia after postoperative radiotherapy. The defect length after hypopharyngeal and cervical esophageal resection was 6-8 cm, and was repaired by a combination of ADM and pectoralis major myocutaneous flap by our team. Interestingly, the four patients had primary healing and regained their eating function about 2-3 weeks after surgery, the fifth individual suffered from pharyngeal fistula, but recovered after dressing change about 2 months. Postoperative esophageal barium meals revealed that the pharynx and esophagus were unobstructed in all five patients. Xenogeneic ADM in combination with pectoralis major myocutaneous flap for hypopharynx and cervical esophagus reconstruction is a simple, safe and effective method with fewer complications. Nevertheless, according to the defect length of the cervical esophagus, the patients need to strictly follow the medical advice.

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“…Pyopneumothorax is a possible complication following reconstruction in patients with esophageal cancer (1). It may be due to anastomotic leakage, benign fistula or empyema with gas-producing bacteria (2).…”

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confidence: 99%

Esophageal Reconstruction with Pyopneumothorax: Double Air-Fluid Level Lesions

Teng

Chen

2012

Intern. Med.

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A 52-year-old man presented with progressive dysphagia and body weight loss for one month. Esophageal cancer with squamous cell carcinoma was diagnosed via esophagoscopy. Then he received subtotal esophagectomy with reconstruction. After the operation, follow-up chest radiograph showed two air-fluid level lesions over both lungs (Picture 1A, B). We performed thoracocentesis and tube drainage to the right lesion (black arrows), which was diagnosed as pyopneumothorax. The left lesion (white arrows) was due to anterior esophageal reconstruction, which was compatible with computed tomography and esophagography (Picture 2).Pyopneumothorax is a possible complication following reconstruction in patients with esophageal cancer (1). It may be due to anastomotic leakage, benign fistula or empyema with gas-producing bacteria (2). Clinical images of pyopneumothorax can mimic reconstruction with presentation of airfluid level lesions. Differential diagnosis can be easily done by recognizing the anastomotic site of reconstruction, chest sonography or computed tomography with esophagography. Tube drainage of a reconstruction lesion which is misdiag-

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Complication following gastric pull-up reconstruction for advanced hypopharyngeal or cervical esophageal carcinoma: a 20-year review in a Chinese institute

Cited by 43 publications

References 15 publications

Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

Xenogeneic acellular dermal matrix in combination with pectoralis major myocutaneous flap reconstructs hypopharynx and cervical esophagus

Esophageal Reconstruction with Pyopneumothorax: Double Air-Fluid Level Lesions

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