Résultats du traitement chirurgical des sténoses caustiques graves pharyngo-œsophagiennes. Intérêt de la reconstruction totale du pharynx par transposition de l'iléon et du côlon

Popovici, Z

doi:10.1016/s0001-4001(99)80003-8

Cited by 8 publications

(1 citation statement)

References 17 publications

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“…Popovici [14] states that in a series of 253 colon or jejunum interpositions with preserved larynx, 70% had a normal diet, 21% had mild dysphagia but were satisfied with their postoperative situation, and 7% had severe dysphagia. However, he did not mention how dysphagia was assessed.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcome Following Colon Interposition in Total Pharyngoesophagectomy with or without Laryngectomy

et al. 2003

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Our study compares deglutition between a group who had undergone total esophagopharyngolaryngectomy and a group who had esophagectomy and partial pharyngectomy with preserved larynx, after reconstruction of the upper digestive tract with pedicled colon interposition. In four patients the laryngeal structures could be preserved (three caustic burns and one proximal esophageal tumor). Six patients underwent a total laryngopharyngectomy for large pharyngeal tumors. Swallowing was assessed by a questionnaire, clinical examination, and videofluoroscopy. All patients had normal intake of semisolid foods and fluids. All patients but three experienced some feeling of "narrowing" of the tract: four at the level of the hypopharynx, two at the oropharyngeal level, one at the oral level. In the laryngectomy group, solid food caused some degree of delayed swallowing in three patients. Dumping occurred in one case out of the nonlaryngectomy group. On clinical examination a tense motility in all laryngectomy patients appeared, food remnants in five and repeated swallowing movements in four. The videofluoroscopy confirmed repeated swallowing movements and presence of residual food in the oral cavity. Temporal stagnation occurred at the anastomosis site in all patients and in two patients at a place of colon redundancy. Colon interposition is a reliable reconstruction and gives the possibility of a good functional outcome. Although preservation of the larynx facilitates swallowing even in this reconstructive procedure, it may be better to perform a total laryngopharyngectomy and colon interposition in oncological cases where the pharyngeal remnant is borderline for primary closure.

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Section: Discussionmentioning

confidence: 99%