J Korean Gastric Cancer Assoc.  2007 Dec;7(4):200-205.

Use of the Stomach as an Esophageal Substitute after Total Pharyngolaryngoesophagectomy for Treating Cervical Esophageal Cancer or Hypopharyngeal Cancer

• Lee SH
• Lee SH
• Yoon HY
• Kim CB

Abstract

PURPOSE: The aim of this study was to analyze the post operative outcome of reconstruction with using the stomach after performing total pharyngolaryngoesophagectomy in patients with hypopharyngeal cancer or cervical esophageal cancer.
MATERIALS AND METHODS
We conducted a retrospective chart review of 23 patients who underwent gastric pull up for esophageal substitution at the Department of Surgery, Yonsei University College of Medicine, between January 1991 and December 2006. All the patients had transhiatal esophagectomy performed without thoracotomy.
RESULTS
There were seventeen males and six females with a median age of 58.1 years (range: 40-70 years). 19 cases were hypopharyngeal cancer, 13 cases had cancer in the pyriform sinus, 15 cases had cancer in the postcricoid area and one case had cancer in the glottic area. The rest were cervical esophageal cancers. The pathologic result was squamous cell carcinoma in all cases. The median total follow-up period was 33 months (range: 1-62 months) and there were two (8.6%) postoperative deaths: one was due to carotid rupture and the other was due to hepatic failure with liver metastasis. The complications were leakage in 1 patient (4.4%), pneumothorax in 1 patient (4.4%) and pneumonia in 1 patient (4.4%).
CONCLUSION
The use of stomach for esophageal reconstruction has many benefits for treating hypopharyngeal cancer or cervical esophageal cancer, So, we made sure there was a sufficient length for the anastomosis after pharyngolaryngoesophagectomy and a rich blood supply from the stomach. There was a low incidence of the leakage at the anastomotic site, along with a low incidence of stenosis and bleeding.

Keyword

Radical total pharyngolaryngoesophagectomy (PLE); Gastric pull up; Pharyngeal cancer; Cervical esophageal cancer

MeSH Terms

Carcinoma, Squamous Cell
Constriction, Pathologic
Esophageal Neoplasms*
Esophagectomy
Female
Follow-Up Studies
Hemorrhage
Humans
Hypopharyngeal Neoplasms*
Incidence
Liver
Liver Failure
Male
Neoplasm Metastasis
Pharyngeal Neoplasms
Pneumonia
Pneumothorax
Pyriform Sinus
Retrospective Studies
Rupture
Stomach*
Thoracotomy