Salvage surgery for recurrent carcinoma of the cervical esophagus postesophagectomy

Abstract

Background Management of cervical esophageal tumor postesophagectomy is mainly palliative because of inadequate exposure of tumor in the cervicothoracic region. In this study, we propose a means of cure for these patients. Methods Between January 2003 and June 2013, 6 patients underwent curative pharyngolaryngectomy and completion cervical esophagectomy via manubrial resection. Operative outcomes were analyzed and compared with a historical cohort who received palliative therapy. Results One patient required prolonged hospital stay for pneumonia, resulting in a median hospital stay of 30 days (range, 21–55 days). All patients resumed oral feeding at a mean of 15.2 days (range, 14–19 days). Tracheostoma stenosis was noted in 2 patients. One patient developed nodal recurrence, another with distant metastasis, resulting in a median disease‐free survival of 13 months (range, 4–20 months). Median overall survival was significantly longer than the cohort group (19.0 vs 3.0 months; p = .013). Conclusion Salvage surgery in patients with carcinoma of the cervical esophagus postesophagectomy is feasible with significantly prolonged survival. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1170–1175, 2015

Esophagogastric Preservation in the Surgical Management of Proximal Esophageal Cancer

“…The esophagus was transected 3 cm distal to the inferior-most border of the tumor. 7 Regional nodal dissection was not routinely performed in the absence of confirmed nodal metastasis. For patients with confirmed cervical nodal metastasis, ipsilateral levels II to IV and VI nodal stations were removed.…”

Free jejunal flap transfer containing multiple vascular pedicles for pharyngoesophageal reconstruction in conjunction with anterior mediastinal tracheostomy

“…However, since resection and reconstruction of the trachea and esophagus each presents with a unique set of challenges, the difficulty and risk of combined tracheal and esophageal reconstruction rise exponentially (Ng, 2015). Not only the complexities of tracheal This paper was presented at the 9th Congress of World Society for Reconstructive Microsurgery (WSRM 2017), Seoul, Korea, 2017. reconstruction but also difficulties associated with digestive tract reconstruction (e.g., anastomotic leakage from the reconstructed digestive tract) inevitably increase the incidence of mediastinitis and mortality (Chow, Chan, & Wei, 2015). Ghali et al (2015) reported that the goals of reconstruction for combined tracheal and esophageal defects are (1) to provide a secure airway, (2) to achieve reliable coverage of major blood vessels, and (3) to restore the continuity of the digestive tract.…”