Case of Superficial Cancer Located at the Pharyngoesophageal Junction Which Was Dissected by Endoscopic Laryngopharyngeal Surgery Combined with Endoscopic Submucosal Dissection.
Aims. In order to determine the indications of transoral surgery for a tumor located at the pharyngoesophageal junction, the trumpet maneuver with transnasal endoscopy was used. Its efficacy is reported here.Material and Methods. An 88-year-old woman complaining of dysphagia, diagnosed with cervical esophageal cancer, and hoping to preserve her voice and swallowing function was admitted to our hospital. Conventional endoscopy showed that the tumor had invaded the hypopharynx. When inspecting the hypopharynx and the orifice of the esophagus, we asked the patient to blow hard and puff her cheeks with her mouth closed (trumpet maneuver). After the trumpet maneuver, the pharyngeal mucosa was stretched out. The pedicle of the tumor arose from the left-anterior wall of the pharyngoesophageal junction, so we decided to perform endoscopic resection.Result. Under general anesthesia, the curved laryngoscope made it possible to view the whole hypopharynx, including the apex of the piriform sinus and the orifice of the esophagus. The cervical esophageal cancer was pulled up to the hypopharynx. Under collaboration between a head and neck surgeon and an endoscopist, the tumor was resected en bloc by endoscopic laryngopharyngeal surgery combined with endoscopic submucosal dissection.Conclusion. Transnasal endoscopy using the trumpet maneuver is useful for a precise diagnosis of the pharyngoesophageal junction. Close collaboration between head and neck surgeons and endoscopists can provide good results in treating tumors of the pharyngoesophageal junction.
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Kenro
0000-0001-9436-454X
K
Kawada
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Tatsuyuki
T
Kawano
Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Taro
T
Sugimoto
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Kazuya
K
Yamaguchi
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yuudai
Y
Kawamura
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Toshihiro
T
Matsui
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Masafumi
M
Okuda
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Taichi
T
Ogo
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yuuichiro
Y
Kume
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yutaka
Y
Nakajima
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Andres
A
Mora
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Takuya
T
Okada
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Akihiro
A
Hoshino
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yutaka
Y
Tokairin
Department of Gastrointestinal Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yasuaki
Y
Nakajima
Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Ryuhei
R
Okada
Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Yusuke
Y
Kiyokawa
Department of Otorhinolaryngology, Tokyo Medical and Dental University, Tokyo, Japan.
Fuminori
F
Nomura
Department of Head and Neck Surgery, Tokyo Medical and Dental University, Tokyo, Japan.
Takahiro
T
Asakage
Department of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Saga, Japan.
Ryo
R
Shimoda
Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan.
Takashi
T
Ito