Carcinoma of the hypopharynx and the cervical oesophagus: a surgical challenge.
OBJECTIVE
To report our results after reconstruction of the upper digestive tract for locally advanced carcinoma of the hypopharynx and cervical oesophagus.


METHODS
Open study.


METHODS
Teaching University hospital, Germany.


METHODS
Of the 517 patients who presented with carcinoma of the oesophagus between September 1985 and March 1997, 16 had a locally advanced tumour of the hypopharynx and 25 of the cervical oesophagus.


METHODS
Free jejunal grafts were used after circular resection in all patients with carcinoma of the hypopharynx, and for the 3 with oesophageal carcinoma in whom we obtained adequate resection margins. In the remainder stomach was used in 21 and colon in 1.


METHODS
Morbidity and mortality.


RESULTS
After jejunal grafting 1 patient died within 30 days and 2 died in hospital. After gastric or colonic reconstruction 2 patients died within 30 days and 4 in hospital. There was 1 anastomotic leak, 1 transplant became necrotic and had to be replaced, in 2 patients the recurrent nerve was damaged, 1 patient developed a wound infection and 1 a cardiac infarction. After gastric or colonic replacement 7 patients had paralysed recurrent laryngeal nerves, there was 6 anastomotic leaks, 1 chylous leak, 1 haemorrhage, and in 1 the transplant necrosed.


CONCLUSIONS
Despite the fact that we compared tumours in different sites, these results suggest that the jejunal graft is safer for upper oesophageal and hypopharyngeal reconstruction.
Böttger
T
T
Department of Surgery, Johannes Gutenberg University Mainz, Germany.
Bumb
P
P
Dutkowski
P
P
Schlick
T
T
Junginger
T
T
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D004947:Esophagus / Q000473:pathology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007013:Hypopharynx / Q000473:pathology / Q000601:surgery; D007583:Jejunum / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D015996:Survival Rate