Technical improvement of total pharyngo-laryngo-esophagectomy for esophageal cancer and head and neck cancer

Masaru Morita, Hiroshi Saeki, Shuhei Ito, Keisuke Ikeda, Nami Yamashita, Koji Ando, Yukiharu Hiyoshi, Satoshi Ida, Eriko Tokunaga, Hideaki Uchiyama, Eiji Oki, Tetsuo Ikeda, Sei Yoshida, Torahiko Nakashima, Yoshihiko Maehara

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: Total pharyngo-laryngo-esophagectomy (PLE) is highly invasive, and the subsequent reconstruction is difficult. The purpose of this study was to clarify the techniques that can decrease the surgical stress and allow for safe reconstruction after this operation. Methods: The surgical method and clinical outcomes of total PLE were reviewed in 12 patients with either cervicothoracic esophageal cancer or double cancer of the esophagus and pharynx. Microscopic venous anastomosis was principally performed, and arterial anastomosis was added, if needed. Results: A narrow gastric tube was used in ten patients, including two patients who underwent free jejunal interposition, while the colon was used as the main reconstructed organ in two other patients. Staged operations were performed in three high-risk patients. All six patients treated after 2010 were able to undergo thoracoscopic and/or laparoscopic surgery. No critical postoperative complications developed, although minor anastomotic leakage developed in two patients who were successfully treated conservatively. Conclusion: When performing PLE, it is important to decrease the surgical stress and ensure a reliable reconstruction by adopting techniques that are appropriate for each case, such as thoracoscopic and laparoscopic surgery, staged operations, microvascular anastomosis, and muscular flaps.

Original languageEnglish
Pages (from-to)1671-1677
Number of pages7
JournalAnnals of Surgical Oncology
Volume21
Issue number5
DOIs
Publication statusPublished - May 2014

    Fingerprint

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this