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- Title
Reconstruction after total pharyngolaryngoesophagectomy : Comparison of elongated stomach roll with microvascular anastomosis with gastric pull up reconstruction or something like that.
- Authors
Sagawa, Noriaki; Okushiba, Shunichi; Ono, Koichi; Ito, Kiyotaka; Morikawa, Toshiaki; Kondo, Satoshi; Katoh, Hiroyuki
- Abstract
Background: We have performed total pharyngolaryngoesophagectomy in case of double cancer, head–neck and thoracic esophageal cancer, or cervical esophageal cancer that extended down to the level of aortic arch. The procedure is very challenging. Methods: From April 1984 to May 1998, 14 patients underwent the procedures for double cancer of head–neck and thoracic esophagus (n=10), hypopharyngeal or cervical esophageal cancer (n=3), and synchronous esophageal cancer (n=1). The grafts used were whole stomach (n=6), elongated stomach roll (n=5), and stomach roll with free jejunum (n=3). The routes of reconstruction were posterior mediastinum (n=10), antesternal (n=3), and retrosternal (n=1). Results: Elongated stomach roll with microvascular anastomoses was long enough for reconstruction and the blood supply of the graft was sufficient. There was no fatal complication in this procedure. Oral feeding was achieved in 13 (93%) patients. Conclusions: The elongated stomach roll with microvascular anastomosis is efficient and the placement of the conduit in the posterior mediastinum is recommended to allow a better alimentary comfort in total pharyngolaryngoesophagectomy.
- Subjects
ESOPHAGEAL cancer; CANCER patients; MICROCIRCULATION disorders; MESOCAVAL shunt; ESOPHAGUS; ALIMENTARY canal
- Publication
Langenbeck's Archives of Surgery, 2000, Vol 385, Issue 1, p34
- ISSN
1435-2443
- Publication type
Article
- DOI
10.1007/s004230050008