Reconstruction of Hypopharyngeal and Esophageal Defects Using a Gastric Tube after Total Esophagectomy and Pharyngolaryngectomy

ORL J Otorhinolaryngol Relat Spec. 2016;78(4):208-15. doi: 10.1159/000446805. Epub 2016 Jul 7.

Abstract

Aim: This study investigated the value of gastric tube during surgery for advanced hypopharyngeal and cervical esophageal cancer.

Method: From November 2007 to December 2012, 42 patients underwent total pharyngo-laryngo-esophagectomy because of advanced hypopharyngeal or cervical esophageal cancer and were reconstructed with a gastric tube. Clinical swallowing function, morbidity, overall survival, and progression-free survival were evaluated postoperatively.

Result: There were no severe complications, including no gastric necrosis, surgery-related postoperative morbidity, hemothorax, thoracostomach, or severe reflux esophagitis. Anastomotic leakage occurred in 2 cases, and these patients healed spontaneously with conservative management. Pulmonary infection developed in 5 patients. Anastomotic stenosis occurred in 2 cases and was managed with endoscopic dilatation. Regurgitation during the night was observed in 5 cases and was controlled by medication. All the patients regained their swallowing ability and thereby increased their quality of life. All patients were followed for 30-60 months; 2 of them were lost 6 months after surgery. The 3-year overall and progression-free survival rates were 58.1 and 56.2% respectively, and the 5-year overall and progression-free survival rates were 27.6 and 21.8%, respectively.

Conclusion: Reconstruction by gastric tube is a dependable one-stage procedure that restores gastrointestinal continuity after total pharyngo-laryngo-esophagectomy.

MeSH terms

  • Aged
  • China
  • Cohort Studies
  • Disease-Free Survival
  • Enteral Nutrition*
  • Esophageal Neoplasms / mortality
  • Esophageal Neoplasms / pathology
  • Esophageal Neoplasms / surgery*
  • Esophagectomy / methods*
  • Follow-Up Studies
  • Humans
  • Hypopharyngeal Neoplasms / mortality
  • Hypopharyngeal Neoplasms / pathology
  • Hypopharyngeal Neoplasms / surgery*
  • Kaplan-Meier Estimate
  • Laryngoscopy / methods
  • Male
  • Middle Aged
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Pharyngectomy / methods*
  • Plastic Surgery Procedures / instrumentation*
  • Plastic Surgery Procedures / methods
  • Quality of Life
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome