Risk factors for complications after pharyngolaryngectomy with total esophagectomy.
BACKGROUND
Pharyngolaryngectomy with total esophagectomy (PLTE) is an effective surgical treatment for synchronous or metachronous hypopharyngeal or laryngeal cancer and thoracic esophageal cancer, although it is more invasive than esophagectomy and total pharyngolaryngectomy. The aim of this study was to identify risk factors for complications after PLTE.


METHODS
From November 2002 to December 2014, a total of 8 patients underwent PLTE at the Shizuoka Cancer Center Hospital, Shizuoka, Japan. We investigated the clinicopathological characteristics, surgical procedures, and postoperative complications of these patients.


RESULTS
Of the 8 patients, 5 underwent one-stage PLTE and 3 underwent staged PLTE. There was no mortality in this study. Two cases of tracheal necrosis, two of anastomotic leakage, and one of ileus were observed as postoperative complications. Two patients who underwent one-stage PLTE with standard mediastinal lymph node dissection developed tracheal necrosis and severe anastomotic leakage.


CONCLUSIONS
One-stage PLTE and standard mediastinal lymph node dissection were identified as the risk factors for severe postoperative complications. Staged PLTE or transhiatal esophagectomy should be considered when PLTE is performed and standard mediastinal lymph node dissection should be avoided when one-stage PLTE is performed with transthoracic esophagectomy.
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan ; Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan.
Eisuke
E
Booka
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Yasuhiro
Y
Tsubosa
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Masahiro
M
Niihara
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Wataru
W
Takagi
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Katsushi
K
Takebayashi
Division of Esophageal Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan ; Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan.
Ayako
A
Shimada
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Takashi
T
Kitani
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Masato
M
Nagaoka
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Atsushi
A
Imai
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Tomoyuki
T
Kamijo
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Yoshiyuki
Y
Iida
Division of Head and Neck Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Tetsuro
T
Onitsuka
Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center Hospital, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777 Japan.
Masahiro
M
Nakagawa
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan.
Hiroya
H
Takeuchi
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582 Japan.
Yuko
Y
Kitagawa
Esophageal cancer; Hypopharyngeal cancer; Pharyngolaryngectomy; Total esophagectomy; Tracheal necrosis
Esophagus. 2016;13:110-137
27110229
Eur Arch Otorhinolaryngol. 2015 Nov;272(11):3551-6
25476198
Dis Esophagus. 2016 Aug;29(6):598-602
26338205
Otolaryngol Head Neck Surg. 2015 Sep;153(3):392-9
26115670
Head Neck. 2015 Aug;37(8):1207-10
24803359
Dis Esophagus. 2014 Apr;27(3):255-61
23672461
Ann Surg Oncol. 1998 Sep;5(6):511-6
9754759
CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
21296855
Ann Surg. 2004 Aug;240(2):205-13
15273542
Ann Surg Oncol. 2014 May;21(5):1671-7
24390709
Ann Surg. 2000 Aug;232(2):225-32
10903602
Medicine (Baltimore). 2015 Aug;94(33):e1369
26287423
JAMA. 1999 May 5;281(17):1623-7
10235156
Ann Surg. 2009 Aug;250(2):187-96
19638912
Ann Surg Oncol. 2014 Apr;21(4):1175-81
24380922
Ann Surg Oncol. 2013 Jul;20(7):2434-9
23358793