title: Palliative total pharyngo-laryngo-esophagectomy.
abstract: OBJECTIVE
  To evaluate the outcomes of total pharyngo-laryngo-esophagectomy (TPLE) as a palliative procedure for achieving oral intake without tube placement.
  
  
  BACKGROUND
  Patients with head and neck cancers require airway maintenance achieved by the placement of a tracheostomy tube and nutrition provided through a gastric fistula or a central vein, which may markedly decrease the quality of life (QOL) of the patients.
  
  
  METHODS
  Two patients with cervical esophageal cancer are described. The first patient was a 69-year-old male with cervical esophageal cancer with vertebral invasion, for which complete resection was not possible. Following TPLE, oral intake was initiated on post-operative day 9 and was maintained for 138 days. The second patient was a 73-year-old male with recurrent cervical esophageal cancer and unresectable lymph node metastasis for which lymph node dissection was not applicable. Following TPLE, oral intake was initiated on post-operative day 7 and was maintained for 199 days. Both patients were satisfied with the outcome.
  
  
  CONCLUSIONS
  The QOL of the two patients was improved following the restoration of oral intake ability. Palliative TPLE may be appropriate for patients with advanced head and neck cancers.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. takezou@jichi.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shinozaki
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Yamazaki
authors.forename: Masakazu
authors.initials: M
authors.lastname: Miyazaki
authors.forename: Toru
authors.initials: T
authors.lastname: Ugumori
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ebihara
authors.forename: Syunji
authors.initials: S
authors.lastname: Sarukawa
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ichimura
mesh_terms: D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology / Q000601:surgery; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007825:Laryngectomy; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D010166:Palliative Care; D010289:Parenteral Nutrition, Total; D017060:Patient Satisfaction; D010611:Pharyngectomy; D011379:Prognosis; D011788:Quality of Life