title: Intraoperative endoscopy in obstructive hypopharyngeal carcinoma.
abstract: OBJECTIVE
  To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.
  
  
  METHODS
  Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7 (22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach.
  
  
  RESULTS
  We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present.
  
  
  CONCLUSIONS
  It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.
authors.affiliation: Department of Esophagogastric Surgery, First Surgical University Hospital, Clinical Center of Serbia, Belgrade, Serbia and Montenegro.
authors.forename: Predrag
authors.initials: P
authors.lastname: Pesko
authors.forename: Milos
authors.initials: M
authors.lastname: Bjelovic
authors.forename: Predrag
authors.initials: P
authors.lastname: Sabljak
authors.forename: Dejan
authors.initials: D
authors.lastname: Stojakov
authors.forename: Ebrahimi
authors.initials: E
authors.lastname: Keramatollah
authors.forename: Dejan
authors.initials: D
authors.lastname: Velickovic
authors.forename: Bratislav
authors.initials: B
authors.lastname: Spica
authors.forename: Branka
authors.initials: B
authors.lastname: Nenadic
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Djuric-Stefanovic
authors.forename: Djordjije
authors.initials: D
authors.lastname: Saranovic
authors.forename: Vera
authors.initials: V
authors.lastname: Todorovic
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000473:pathology / Q000601:surgery*; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000473:pathology