Reconstruction of Hypopharynx and Cervical Oesophagus for Treatment of Advanced Hypopharyngeal Carcinoma and Recurrent Laryngeal Carcinoma
Article Outline
Objective
To review our treatment strategy and outcomes in reconstructing the hypopharynx and cervical oesophagus with five techniques for advanced hypopharyngeal carcinoma and recurrent laryngeal carcinoma.
Methods
Thirty-one patients treated between 1996 and 2007 were analysed retrospectively. Defects of the hypopharynx and cervical oesophagus were reconstructed using the remaining laryngeal mucosa flap, pectoralis major myocutaneous flap, forearm free flap, jejunal free flap or latissimus dorsi myocutaneous flap.
Results
All patients were treated successfully. Postoperative pharyngocutaneous fistulas occurred in four patients, one of whom died from haemorrhage of carotid artery 1 month after surgery, and the other three resolved spontaneously. Dysphagia occurred in three patients, which was caused by food mass occlusion, or oesophageal stricture and stoma stricture. The 3- and 5-year survival rates were 59.3% and 43.5%, respectively.
Conclusion
A consensus treatment strategy for reconstructing the defect following hypopharyngectomy and cervical oesophagectomy has not been established. Every technique has its advantages and disadvantages. The treatment of choice depends upon the location and size of the carcinoma as well as the patient's characteristics and the doctor's experience.
Key Words: hypopharyngeal carcinoma , laryngeal carcinoma , laryngectomy , pharyngectomy , reconstruction
No full text is available. To read the body of this article, please view the PDF online.
References
- . Contralateral hemilaryngotracheal flap reconstruction of the hypopharynx in pyriform carcinoma resection . Laryngoscope . 1999;109:221–225
- . Pectoralis major myocutaneous flap reconstruction of the laryngopharynx and cervical esophagus . Laryngoscope . 1988;98:1227–1231
- . Latissimus dorsi perforator flap . Clin Plast Surg . 2003;30:403–431
- . Reconstruction with radial forearm flaps after ablative surgery for hypopharyngeal cancer . Head Neck . 2003;25:261–266
- . Reconstruction of the hypopharynx with the free jejunum transfer . J Surg Oncol . 2006;94:466–470
- . Laryngopharyngectomy with reconstruction . Otolaryngol Clin North Am . 2002;35:1097–1114
- . Histopathologic study of carcinoma of the hypopharynx implication for conservation surgery . Ann Otol Rhinol Laryngol . 1981;96:625–629
- Hemilaryngeal flap for hypopharyngeal reconstruction in pyriform sinus carcinoma . Acta Otolaryngol . 2007;127:4–7
- The use of processed allograft dermal matrix for intraoral resurfacing . Arch Otolaryngol Head Neck Surg . 1998;124:1201–1204
- . Hemipharyngectomy and hemilaryngectomy for pyriform sinus cancer: reconstruction with remaining larynx and hypopharynx and with tracheotomy . Laryngoscope . 1993;103:82–86
- . Reconstruction of the pharynx after resection for cancer. A comparison of methods . Ann Surg . 1989;209:554–560
- Radial forearm free flap pharyngoesophageal reconstruction . Laryngoscope . 2001;111:807–810
- . Reconstructive techniques currently used following resection of hypopharyngeal carcinoma . J Laryngol Otol . 1999;113:145–148
PII: S1015-9584(10)60003-6
doi:10.1016/S1015-9584(10)60003-6
© 2010 Asian Surgical Association. Published by Elsevier Inc. All rights reserved.
