[Surgical treatment of carcinoma of the hypopharynx and cervical esophagus].
Between 1975 and 1988 we observed 169 patients with carcinoma of the cervical esophagus, 85 a carcinoma involving the hypopharynx and the cervical esophagus, and 27 patients with a carcinoma of the cervical esophageal region arose after laryngectomy for laryngeal cancer. The mean age was 57.5 years (range 41-73). 167 patients underwent surgical exploration (operability rate 59.5%) and in 152 cases the tumor was resected (resectability rate 91.1%). The resection was complete in 129 patients (84.9%) and palliative in 23 (14.1%). In 33 cases of laryngo-pharyngo-cervical segmentary esophagectomy with free intestinal loop transplantation was performed with an operative mortality of 6.1%. 101 patients underwent laryngo-pharyngo-total esophagectomy and the digestive tract was reconstructed by means of pharyngo-gastrostomy and pharyngo-colostomy in 85 and 16 cases, with an operative mortality of 12.9% and 18.3%, respectively. Total esophagectomy without laryngectomy was performed in 18 patients with a carcinoma of the distal cervical esophagus refusing laryngectomy with an hospital mortality of 5.5%. The overall 5-year actuarial survival, excluding the operative mortality, was 15.8%. After complete resection, better results were recorded with patients operated for carcinoma of the hypopharynx than with patients with carcinoma of the cervical esophagus: the 2-year and 5-year actuarial survival was 59% vs 26% and 43% vs 17%, respectively. No patient undergoing palliative resection was alive at the 3-year interval.(ABSTRACT TRUNCATED AT 250 WORDS)
Istituto di Clinica Chirurgica I, Università di Padova.
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Peracchia
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Bardini
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Ruol
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Castoro
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Segalin
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M
Asolati
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S
Lazzaro
E
E
Tiso
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D003106:Colon / Q000601:surgery; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000601:surgery*; D008722:Methods; D008875:Middle Aged; D009333:Neck; D010166:Palliative Care; D010614:Pharynx / Q000601:surgery; D013270:Stomach / Q000601:surgery
Il trattamento chirurgico dei carcinomi dell'ipofaringe e dell'esofago cervicale.