[Total pharyngolaryngoesophagectomy with free jejunal transfer for a patient who previously underwent distal esophagectomy with gastric tube reconstruction via a posterior mediastinal route].
The patient in this case study was a 71-year-old male who underwent distal esophagectomy with gastric tube reconstruction via a posterior mediastinal route for esophageal cancer 12 years previously. An endoscopy revealed a hypopharyngeal tumor in the right piriform fossa, and the histopathological diagnosis, based on a biopsy sample, was squamous cell carcinoma. Preoperative angiography of the right gastroepiploic artery revealed poor blood flow in the remnant esophagus. First, the adhesion of the gastric tube to the surrounding tissue was dissected via a right thoracotomy. Then, the gastric tube was raised using a cervical approach, and total pharyngolaryngoesophagectomy with free jejunal transfer was performed. The patient was discharged 28 days after the operation without complications. We report a patient with hypopharyngeal cancer who had previously undergone distal esophagectomy with gastric tube reconstruction via a posterior mediastinal route upon whom we successfully performed a total pharyngolaryngoesophagectomy with free jejunal transfer. In such a case, it is important to carefully decide the surgical approach in order to prevent anastomotic leakage.
Dept. of Surgery, Division of Digestive Surgery, Kyoto Prefectural University of Medicine.
Sachie
S
Tanaka
Atsushi
A
Shiozaki
Hitoshi
H
Fujiwara
Hirotaka
H
Konishi
Toshiyuki
T
Kosuga
Ryo
R
Morimura
Yasutoshi
Y
Murayama
Shuhei
S
Komatsu
Yoshiaki
Y
Kuriu
Hisashi
H
Ikoma
Masayoshi
M
Nakanishi
Daisuke
D
Ichikawa
Kazuma
K
Okamoto
Chouhei
C
Sakakura
Eigo
E
Otsuji
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000601:surgery*; D016629:Esophagectomy; D005743:Gastrectomy; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D008297:Male; D019651:Plastic Surgery Procedures; D013270:Stomach / Q000601:surgery