Total pharyngolaryngectomy and cervical esophagectomy with jejunal autotransplant reconstruction: complications and results.
Eighteen patients underwent pharyngoesophageal reconstruction with a free jejunal autotransplant in a one-stage procedure after circumferential resection for cancer of the pharynx and cervical esophagus. Of these, six had minor complications (fistulas) and six had major complications including abdominal bleeding, cervical bleeding, graft failure, and one surgical death. The mean survival was 427 days after resection and reconstruction (range, 120 to 866 days). Ten patients died of their disease, and four died of other causes. The site of failure was local in five and distant in five. In view of this high complication rate and unimpressive survival rate, the use of other lower-morbidity reconstructive options or staged procedures may need to be considered in poor surgical candidates.
Ferguson
J L
JL
Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN.
DeSanto
L W
LW
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D004938:Esophageal Neoplasms / Q000601:surgery*; D004944:Esophagoplasty / Q000379:methods; D004947:Esophagus / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006084:Graft Rejection; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000601:surgery*; D010611:Pharyngectomy; D011183:Postoperative Complications; D014831:Voice