The advanced hypopharyngeal cancers surgery treatment complications
Journal Title: Otolaryngologia Polska - Year 2011, Vol 65, Issue 5
Abstract
SUMMARY Introduction: Hypopharynx is the anatomical region created by strictly functionally connected regions: two pyriform sinuses, retrocricoid region and the posterior pharyngeal wali on its level. Hypopharyngeal Cancer is in 95% planoepithelial carcinoma, it constitute about 5-10% of all malignant tumors of the upper part of digestive tract and the respiratory system. Occult early symptoms make it advanced stages detectible. It easily spreads in to surrounding anatomical structures such as: larynx, oral cavity, oropharynx, esophagus, prevertebral space. It gives relatively quick and common metas-tases to lymph nodes (opposed or both sites). Aim: The aim of our study is to analyze the complications of the advanced hypopharyngeal tumor surgery. Material and Methods: Material was 53 patients treated for advanced hypopharyngeal cancer (or hypopharyngeal cancer with larynx and cervical part of esophagus involved), in Otolaryngology Clinic, Medical University of Warsaw, between 1999 and 2010. We performed the circular removal of hypopharynx, cervical part of esophagus and larynx with concomitant diges-tive tract reconstruction by autotransplantation of the jejunum (41 cases) or the ileocecal segment (12 cases). In most cases surgery was extended to lymph nodes removal. Results: In our group of patients we had complications such as: Intraoperative complications of surgery — the intestine transplant ischemia. Early post operative complications — transplant ischemia, salivary fistula, hematoma of postopera-tive cavity (without necrosis of the transplant), massive arterial anastomosis bleeding, and wound infection. Late postoperative complications — late salivary fistula, tracheostomy stenosis, local tumor recurrence, spread of the cancer and swallowing disorder. The different complications were very uncommon. Conclusion: 1. Discussed method of the digestive tract reconstruction after extensive, advanced laryneal, hypopharyngeal, and the cervical part of esophagus tumors surgery entails intraoperative and postoperative complications. 2. As we compered the extension of the surgery and the advanced tumor process with number of complications, it seemed to be few. Such method of the reconstruction is most physiologic one, and it lets patients to avoid the gastrostomy or other inconvenience of parenteral nutrition
Authors and Affiliations
Ewa Osuch-Wójcikiewicz, Piotr Chęciński, Antoni Bruzgielewicz, Jagna Nyckowska, Sławomir Nazarewski
Keywords
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