title: Salvage total pharyngolaryngectomy and free jejunum transfer.
abstract: OBJECTIVE
  The objective of this retrospective study was to examine the safety and efficacy of free jejunum transfer after total pharyngolaryngectomy after radiotherapy (RT) or chemoradiotherapy (CRT) to the neck for patients with recurrent or second primary disease.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  A total of 313 patients were divided into two groups on the basis of a history of RT to the neck: 86 patients had received RT and 227 patients had not. The patients who had received RT were subdivided on the basis of the type of previous treatment: those who had received RT alone (32 patients) and those who had undergone concurrent CRT (54 patients). Postoperative complications were compared between RT and non-RT groups and between the RT-alone and CRT groups.
  
  
  RESULTS
  The rates of complications did not differ significantly between the RT and non-RT groups, but the rates of anastomotic thrombosis and carotid rupture were slightly but not significantly higher in the RT group than in the non-RT group. The overall complication rate did not differ between the RT-alone group and the CRT group.
  
  
  CONCLUSIONS
  Pharyngolaryngectomy and free jejunum transfer can be performed safely, even in patients who have received RT, without significant increases in morbidity or mortality. However, a risk of carotid rupture due to pharyngocutaneous fistula remains in patients who have received RT, and prevention and early detection of fistulas are crucial. The risk of postoperative complications is not higher with CRT than with RT alone.
authors.affiliation: Division of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan. shimiyam@ncc.go.jp
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.forename: Shogo
authors.initials: S
authors.lastname: Nagamatsu
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D007583:Jejunum / Q000637:transplantation*; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery*; D007825:Laryngectomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016879:Salvage Therapy