[Clinical inspection of metastasis to the mesenteric lymph nodes in patients with hypopharyngeal cancer after pharyngolaryngectomy with free jejunal graft-136 cases].
Single-stage reconstruction of the pharyngoesophagus with a free jejunal graft is considered standard surgical treatment for hypopharyngeal cancer. We reviewed postoperative cervical CTs in 72 of 136 consecutive patients (1982-2002) undergoing this therapy in our department. Of these, 29 (40%) showed mesenteric lymph node swelling (> 10mm) in grafts. Most swelling is considered reactive, but 1 patient showed pathological metastasis in fine-needle aspiration cytology (FNA). When metastasis is clinically suspected in imaging study and other examinations, FNA should be done carefully with guided ultrasound echo-imaging, to avoid damaging vascular grafts and necrosis of the jejunal graft.
Division of Otolaryngology, Hitachi General Hospital, Ibaraki.
Sayaka
S
Suzuki
Masato
M
Mochiki
Kazunari
K
Nakao
Takashi
T
Sakamoto
Mizuo
M
Ando
Masashi
M
Sugasawa
D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation*; D007825:Laryngectomy; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D010611:Pharyngectomy; D019651:Plastic Surgery Procedures / Q000379:methods