Technical Improvement of Total Pharyngo-Laryngo-Esophagectomy for Esophageal Cancer and Head and Neck Cancer
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- 作者：Masaru Morita MD ; PhD ; FACS (1) (2)
Hiroshi Saeki MD ; PhD ; FACS (1)
Shuhei Ito MD ; PhD (1)
Keisuke Ikeda MD (1)
Nami Yamashita MD ; PhD (1)
Koji Ando MD ; PhD (1)
Yukiharu Hiyoshi MD ; PhD (1) (2)
Satoshi Ida MD ; PhD (1)
Eriko Tokunaga MD ; PhD (1)
Hideaki Uchiyama MD ; PhD (1)
Eiji Oki MD ; PhD ; FACS (1)
Tetsuo Ikeda MD ; PhD (1)
Sei Yoshida MD (3)
Torahiko Nakashima MD ; PhD (3)
Yoshihiko Maehara MD ; PhD ; FACS (1) - 刊名：Annals of Surgical Oncology
- 出版年：2014
- 出版时间：May 2014
- 年：2014
- 卷：21
- 期：5
- 页码：1671-1677
- 全文大小：3,027 KB
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Hiroshi Saeki MD, PhD, FACS (1)
Shuhei Ito MD, PhD (1)
Keisuke Ikeda MD (1)
Nami Yamashita MD, PhD (1)
Koji Ando MD, PhD (1)
Yukiharu Hiyoshi MD, PhD (1) (2)
Satoshi Ida MD, PhD (1)
Eriko Tokunaga MD, PhD (1)
Hideaki Uchiyama MD, PhD (1)
Eiji Oki MD, PhD, FACS (1)
Tetsuo Ikeda MD, PhD (1)
Sei Yoshida MD (3)
Torahiko Nakashima MD, PhD (3)
Yoshihiko Maehara MD, PhD, FACS (1)
1. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
2. Department of Surgery and Molecular Targeting Therapy, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
3. Department of Oto-Rhino-Laryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan - ISSN：1534-4681
文摘
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.