Free vascularized jejunum interposition for pharyngoesophageal reconstruction after total laryngopharyngectomy.
The records of 28 patients who underwent free jejunal graft reconstruction after resection for cancer involving the pharynx were analysed. Seven patients had a T3 carcinoma, 15 patients T4 and six patients recurrence after laryngectomy. Ten patients had received radiotherapy in the past. Post-operatively, 15 patients (54%) had complications and two patients (7%) died. No significant difference was observed in the complication rate between the group that received radiotherapy in the past and those who did not. Nineteen patients received post-operative radiotherapy. Nine patients had no radiotherapy on the basis of complete resection or because of serious complications. For the whole group the 2-year recurrence free period and survival were 42% and 51% respectively. The post-operative radiotherapy group had a significantly better survival (73%) and recurrence free period (63%) than the group without post-operative radiotherapy (0%). Thus, post-operative radiotherapy seems indicated irrespective of resection margins.
Hoorweg
J J
JJ
Department of Oto-Rhino-Laryngology Head & Neck Surgery, Free University, Amsterdam, The Netherlands.
Rauwerda
J A
JA
Croll
G A
GA
Mackaay
A J
AJ
Risse
E K
EK
De Vries
N
N
Tiwari
R M
RM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D017577:Cutaneous Fistula / Q000209:etiology; D018572:Disease-Free Survival; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000209:etiology; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy / Q000379:methods / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D009367:Neoplasm Staging; D010608:Pharyngeal Diseases / Q000209:etiology; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D010611:Pharyngectomy / Q000379:methods / Q000534:rehabilitation*; D010614:Pharynx / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications; D012189:Retrospective Studies; D015996:Survival Rate