Hemolytic Reactions Associated With Surgical Procedures

Pharyngo-Laryngectomy with Primary “Sleeve Graft” Reconstruction

“…We would agree with Conley (1953) who states that total pharyngolaryngectomy with primary closure by skin tube must be used when resection of the primary tumour in the hypopharynx or cervical oesophagus necessitates excision of more than 70 per cent, of the mucosal circumference. Any less extensive circumferential involvement will allow the preservation of at least a mucosal strip in continuity with the pharynx and oesophagus, the whole of which may then be closed around a small calibre feeding tube.…”

“…Tantalum wire mesh has been popular since it is easily shaped and trimmed to suit each individual case (Rob and Bateman, 1949, Edgerton, 1952, Ashley et al, 1955. Another surgeon has recently been using woven nylon as a suitable stent (Conley, 1955). But polyethylene tubing has probably been most widely employed since it is both easily trimmed and provides a more satisfactory mechanical support (Owen, 1952;Cade, Reidy et al, 1953;Negus, 1953).…”

“…Frequent emphasis is given to the particular importance of accurate and meticulous suturing without tension or irregularity at the upper and lower ends where healing is apt to be more prejudiced (Reidy, 1953;Conley, 1953;Owen, 1954). We are also convinced that the utmost care in placement and suturing of the graft is essential for success.…”