Late complications after pharyngogastrostomy.
A case of severe stricture and a case of tracheogastric fistula after laryngopharyngo-esophagectomy and pharyngogastrostomy for cervical esophageal cancer are described. Stricture is often seen but tracheogastric fistula is a rare complication, however, both are devastating conditions. According to the literature, the survival rate is poor in both cases. The surgical management demands several principles. Recurrent or metastatic cancer must be ruled out. The patients' general condition and nutritional status must be optimized. Pulmonary infection must be cleared. The surgical management of the stricture was a free jejunal transfer after failed attempts of several dilation procedures. The treatment of tracheogastric fistula was suturing the stomach and covering the trachea with a pedicled left sternocleidomastoideus flap. The survival of the patient treated with free jejunal interposition exceeds 24 month. Unfortunately, the patient with tracheogastric fistula, treated with interpositioned sternocleidomastoideus muscular flap, lived two weeks after this operation. The surgical managements described in this report may provide palliation or definitive treatment for these devastating complications.
Endrédi
J
J
1st Surgical Department, Medical University of Pécs, Hungary.
Horváth
O P
OP
D002277:Carcinoma / Q000556:secondary / Q000601:surgery; D004938:Esophageal Neoplasms / Q000601:surgery; D004940:Esophageal Stenosis / Q000209:etiology*; D016629:Esophagectomy / Q000009:adverse effects; D005402:Fistula / Q000209:etiology*; D005500:Follow-Up Studies; D005747:Gastric Fistula / Q000209:etiology*; D006801:Humans; D007583:Jejunum / Q000637:transplantation; D007825:Laryngectomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009334:Neck Muscles / Q000637:transplantation; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009752:Nutritional Status; D010166:Palliative Care; D010611:Pharyngectomy / Q000009:adverse effects; D010614:Pharynx / Q000601:surgery*; D011183:Postoperative Complications; D013270:Stomach / Q000601:surgery*; D013524:Surgical Flaps; D015996:Survival Rate; D013536:Suture Techniques; D014133:Tracheal Diseases / Q000209:etiology*; D014139:Tracheostomy / Q000009:adverse effects