Reconstruction with free jejunal autograft after pharyngolaryngoesophagectomy.
Twenty-four patients with hypopharyngeal or cervical esophageal carcinoma were treated surgically. All had squamous cell carcinoma, and none had intrathoracic lymph node involvement by preoperative computed tomography. Endoscopy in 18 patients confirmed there was no intramural spread into the thoracic esophagus. The patients underwent pharyngolaryngoesophagectomy and bilateral modified radical neck dissection. Reconstruction of the cervical esophagus was performed with transplantation of a free jejunal autograft. Postoperative complications included anastomotic leak in 2 patients (8.3%), wound infection in 3 (12.5%), and intussusception in 4 (16.7%). Reconstruction of the cervical esophagus was successful in 23 (95.8%) of the 24 patients. The operative mortality rate was 4.2%, and the 5-year survival rate was 39.7%. We emphasize that pharyngolaryngoesophagectomy followed by transplantation of a free jejunal graft is suitable for cervical esophageal carcinoma or hypopharyngeal carcinoma when the disease is limited to the cervical region.
Omura
K
K
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Misaki
T
T
Watanabe
Y
Y
Urayama
H
H
Hashimoto
T
T
Matsu
T
T
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D010611:Pharyngectomy / Q000534:rehabilitation; D011183:Postoperative Complications / Q000401:mortality; D016896:Treatment Outcome