Palliative total pharyngo-laryngo-esophagectomy.
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.
Shinozaki
Takeshi
T
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
Hayashi
Ryuichi
R
Yamazaki
Mitsuo
M
Miyazaki
Masakazu
M
Ugumori
Toru
T
Sakuraba
Minoru
M
Ebihara
Satoshi
S
Sarukawa
Syunji
S
Ichimura
Keiichi
K
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