Digestive Reconstruction After Pharyngolaryngectomy with Total Esophagectomy

Okamura, Akihiko; Watanabe, Masayuki; Kanamori, Jun; Imamura, Yu; Takahashi, Keita; Ushida, Yuta; Kamiyama, Ryosuke; Seto, Akira; Shimbashi, Wataru; Sasaki, Tōru; Fukushima, Hirofumi; Yonekawa, Hiroyuki; Mitani, Hiroki

doi:10.1245/s10434-020-08830-x

Cited by 5 publications

(14 citation statements)

References 21 publications

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“…Studies have shown that a gastric tube had been most commonly used method for digestive reconstruction after PLTE. In fact, studies have shown that among patients who underwent gastric tube reconstruction, 3.3%–25.0% and 0%–16.7% developed anastomotic leakage and gastric necrosis, respectivley 1‐4,9,10,12,14 . In the present study, overall DRRCs in a simple gastric tube and gastric tube with MVA were observed in 28.6% and 26.5%, respectively.…”

Section: Discussionsupporting

confidence: 51%

“…In fact, studies have shown that among patients who underwent gastric tube reconstruction, 3.3%-25.0% and 0%-16.7% developed anastomotic leakage and gastric necrosis, respectivley. [1][2][3][4]9,10,12,14 In the present study, overall DRRCs in a simple gastric tube and gastric tube with MVA were observed in 28.6% and 26.5%, respectively. Previous studies have reported that additional MVA to a simple gastric tube could promote better outcomes compared to simple gastric tube reconstruction alone.…”

Section: Ta B L E 1 Patient Characteristics and Surgical Proceduressupporting

confidence: 47%

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A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan

Okamura

Watanabe

Mukoyama

et al. 2021

Annals of Gastroent Surgery

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Aim Digestive reconstruction after pharyngolaryngectomy with total esophagectomy (PLTE) remains challenging, with the optimal method remaining unclear. The current study aimed to clarify the short‐term outcomes after PLTE and determine the optimal digestive reconstruction method. Methods Based on a nationwide survey of 151 patients who underwent PLTE, outcomes of digestive reconstruction methods are described. Results Among digestive reconstruction methods, a simple gastric tube was most frequently used (37.1%), followed by gastric tube combined with free graft transfer (FGT) (35.1%), gastric tube with microvascular anastomosis (22.5%), and other procedures (5.3%). Intraoperative evaluation of microcirculation (IOEM) was utilized in 29 patients (19.2%). Among the included patients, 66.9% developed any‐grade complications, 41.0% developed severe complications, and 23.8% developed digestive reconstruction‐related complications (DRRCs; leakage or necrosis). Reoperation within 30 days for any complications and DRRCs was required in 13.9% and 8.6% of the patients, respectively. Mortality within 90 days was observed in 4.6%. Among the three major methods, gastric tube combined with FGT promoted the least DRRCs in the gastric tube (P = .005), although the overall incidence of DRRCs was comparable. The use of IOEM was significantly associated with a reduction of severe DRRCs (P = .005). Conclusions Pharyngolaryngectomy with total esophagectomy is a high‐risk surgery significantly associated with the occurrence of postoperative morbidity and mortality. Nonetheless, the addition of FGT can help prevent gastric tip complications, while IOEM can be an effective method for improving outcomes.

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Section: Discussionsupporting

confidence: 51%

Section: Ta B L E 1 Patient Characteristics and Surgical Proceduressupporting

confidence: 47%

A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan

Okamura

Watanabe

Mukoyama

et al. 2021

Annals of Gastroent Surgery

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“…We therefore performed elongated gastric conduit with MVA as reconstruction. Anastomotic leakage and graft failure of the elongated gastric conduit with MVA after PLTE were reported to be significantly reduced compared with simple gastric conduit without MVA after PLTE 9 . In the case of elongated gastric conduit with MVA, less tension than by simple gastric conduit may be due to the reduction of anastomotic leakage.…”

Section: Discussionmentioning

confidence: 93%

“…Anastomotic leakage and graft failure of the elongated gastric conduit with MVA after PLTE were reported to be significantly reduced compared with simple gastric conduit without MVA after PLTE. 9 In the case of elongated gastric conduit with MVA, less tension than by simple gastric conduit may be due to the reduction of anastomotic leakage. In addition, reconstruction with elongated gastric conduit may have less anastomotic leakage than free jejunal interposition, because there is only one anastomosis.…”

Section: Discussionmentioning

confidence: 99%

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Pharyngolaryngectomy with thoracoscopic esophagectomy via the left thoracic approach for cervical esophageal cancer with right aortic arch: Case report

Nagano

Kitadani

Ojima

et al. 2022

Asian J Endoscop Surgery

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We performed pharyngolaryngectomy with thoracoscopic esophagectomy via the left thoracic approach and reconstruction of the elongated gastric conduit with microvascular anastomosis for an 83-year-old male patient with esophageal cancer and right aortic arch. For such cases, a surgical approach via the left thoracic cavity is rational, and cases of pharyngolaryngectomy with thoracoscopic esophagectomy require a long reconstruction organ. Also, in cases of right aortic arch, a longer reconstruction route is made to avoid Kommerell's diverticulum. The patient had laryngeal cancer and was diagnosed with cervical

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Surgical outcomes of reconstruction using the gastric tube and free jejunum for cervical esophageal cancer: analysis using the National Clinical Database of Japan

et al. 2023

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Digestive Reconstruction After Pharyngolaryngectomy with Total Esophagectomy

Cited by 5 publications

References 21 publications

A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan

A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan

Pharyngolaryngectomy with thoracoscopic esophagectomy via the left thoracic approach for cervical esophageal cancer with right aortic arch: Case report

Surgical outcomes of reconstruction using the gastric tube and free jejunum for cervical esophageal cancer: analysis using the National Clinical Database of Japan

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