Risk factors for complications after pharyngolaryngectomy with total esophagectomy

Abstract

BackgroundPharyngolaryngectomy with total esophagectomy (PLTE) is an effective surgical treatment for synchronous or metachronous hypopharyngeal or laryngeal cancer and thoracic esophageal cancer, although it is more invasive than esophagectomy and total pharyngolaryngectomy. The aim of this study was to identify risk factors for complications after PLTE.MethodsFrom November 2002 to December 2014, a total of 8 patients underwent PLTE at the Shizuoka Cancer Center Hospital, Shizuoka, Japan. We investigated the clinicopathological characteristics, surgical procedures, and postoperative complications of these patients.ResultsOf the 8 patients, 5 underwent one-stage PLTE and 3 underwent staged PLTE. There was no mortality in this study. Two cases of tracheal necrosis, two of anastomotic leakage, and one of ileus were observed as postoperative complications. Two patients who underwent one-stage PLTE with standard mediastinal lymph node dissection developed tracheal necrosis and severe anastomotic leakage.ConclusionOne-stage PLTE and standard mediastinal lymph node dissection were identified as the risk factors for severe postoperative complications. Staged PLTE or transhiatal esophagectomy should be considered when PLTE is performed and standard mediastinal lymph node dissection should be avoided when one-stage PLTE is performed with transthoracic esophagectomy.

Induction chemotherapy for the individualised treatment of hypopharyngeal carcinoma with cervical oesophageal invasion: a retrospective cohort study

“…In recent years, there have been several reports of post-operative repair and reconstruction [ 10 , 11 ]. In this study, reconstruction of the pharynx and digestive tract was primarily performed using one of the three methods described previously [ 10 , 12 , 13 ]. For unilateral pyriform sinus carcinomas where the lesion invades the oesophageal inlet and does not reach the circumference of the cavity of the oesophageal canal, but infiltrates downward for up to 2–3 cm, it is possible to repair the residual hypopharyngeal mucosa and upper oesophageal mucosa using a pectoralis major myocutaneous flap.…”

Induction Chemotherapy for the Individualized Treatment of Hypopharyngeal Cancer with Oesophageal Invasion: A Retrospective Cohort Study

“…In recent years, there have been many reports on the postoperative repair and reconstruction of advanced hypopharyngeal cancer (8)(9). In this study, the reconstruction of the pharynx and digestive tract was performed mainly by one of the three different methods described in previous studies (8,10,11). For unilateral piriform sinus carcinoma, the lesion invaded the oesophageal inlet and did not reach the circumference of the oesophageal canal cavity but in ltrated downward for up to 2-3 cm, and it is feasible to repair the residual hypopharyngeal mucosa and the upper oesophageal mucosa with a pectoralis major myocutaneous ap.…”

Induction chemotherapy for the individualised treatment of hypopharyngeal carcinoma with cervical oesophageal invasion: a retrospective cohort study

“…In recent years, there have been several reports of post-operative repair and reconstruction (9,10). In this study, reconstruction of the pharynx and digestive tract was primarily performed using one of the three methods described previously (9,11,12). For unilateral pyriform sinus carcinomas where the lesion invades the oesophageal inlet and does not reach the circumference of the cavity of the oesophageal canal, but in ltrates downward for up to 2-3 cm, it is possible to repair the residual hypopharyngeal mucosa and upper oesophageal mucosa using a pectoralis major myocutaneous ap.…”