[The latest results of the advanced hypopharyngeal cancer surgery with immediate reconstruction using the free jejunal autograft].
In 21 patients with T3, T4 pharyngo-laryngeal cancer circumferential resection with immediate reconstruction using a free revascularized jejunal autograft was performed. In 13 cases the jejunal reconstruction was successful. In patients previously not irradiated the rate of success was 75% and in irradiated ones 37.5%. Five patients survived more than 5 years: one more than 7, two more than 6 and one more than 5. One patient with an unsuccessful jejunal graft and with subsequent skin reconstruction survived more than 6 years. The causes of failure were:-irreversible spasm of the arteries in 2 cases, skinking of the vessels resulting in flap necrosis in flap necrosis in 2 cases, -necrosis due to widespread atherosclerosis of the cervical arteries in 3 cases and of an unknown cause in 1 case. The cause of death was: widespread metastases in 12 cases, C.V.A. in 1 case, road traffic accident in 1 case, complications of the ileus in 1 case and carotid artery haemorrhage in 1 case. One of the successful patients was irradiated postoperatively, because the pathology report stated there was incomplete resection, and survived more than 6 years with no disturbance of swallowing. In general 10 patients died in the first year, 4 in the second, 1 in the third and 1 in the fourth--without any signs of recurrence. The five year survival of 24% in the presented group is relatively high in comparison with the generally accessible data for T3, T4 hypopharyngeal carcinoma treated by any of the usual methods.
Klinika Otolaryngologii AM, Warszawie.
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T
Jegliński
J
J
Szmidt
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Z
Szlenk
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S
Frunze
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D007822:Laryngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy; D007830:Larynx / Q000473:pathology* / Q000528:radiation effects; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D010614:Pharynx / Q000473:pathology* / Q000528:radiation effects; D013534:Survival; D014182:Transplantation, Autologous
Odległe wyniki operacji zaawansowanego raka gardła dolnego z jednoczasowym odtworzeniem wolnym autoprzeszczepem jelita cienkiego.