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Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

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Title: Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision
Authors: Homma, Akihiro Browse this author →KAKEN DB
Nakamaru, Yuji Browse this author →KAKEN DB
Hatakeyama, Hiromitsu Browse this author →KAKEN DB
Mizumachi, Takatsugu Browse this author →KAKEN DB
Kano, Satoshi Browse this author →KAKEN DB
Furusawa, Jun Browse this author
Sakashita, Tomohiro Browse this author →KAKEN DB
Shichinohe, Toshiaki Browse this author →KAKEN DB
Ebihara, Yuma Browse this author →KAKEN DB
Hirano, Satoshi Browse this author →KAKEN DB
Furukawa, Hiroshi Browse this author →KAKEN DB
Hayashi, Toshihiko Browse this author
Yamamoto, Yuhei Browse this author →KAKEN DB
Fukuda, Satoshi Browse this author →KAKEN DB
Keywords: Cervical esophageal cancer
Hypopharyngeal cancer
Postoperative complication
Minimally invasive esophagectomy
Issue Date: Nov-2015
Publisher: Springer
Journal Title: European archives of oto-rhino-laryngology
Volume: 272
Issue: 11
Start Page: 3551
End Page: 3556
Publisher DOI: 10.1007/s00405-014-3420-9
PMID: 25476198
Abstract: Total laryngo-pharyngo-esophagectomy (TLPE) with gastric pull-up reconstruction is still considered to be associated with major complications and a significant risk of in-hospital death. Minimally invasive esophagectomy, avoiding thoracotomy and laparotomy, has been increasingly performed for esophageal malignancies with the hope of reducing mortality and morbidity, such as pulmonary complications. The aim in this study was to assess early and long-term morbidity as well as treatment outcomes in patients treated with TLPE with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision. From 2004 to 2013, 10 patients with a median age of 64 years (range 47-71 years) underwent minimally invasive TPLE with gastric pull-up reconstruction. Seven of the 10 patients had previously received radiotherapy. As for early postoperative complications, no patient died during the early postoperative period, and pneumonia was observed in 1, skin necrosis in 1, pseudomembranous enterocolitis in 1, arrhythmia in 2, hemorrhage in the neck in 2, anastomotic leakage in the neck in 3, and tracheal necrosis in 6 patients. Three patients developed tracheostomal stenosis as a long-term postoperative complication, and an anastomotic stricture was observed in one patient. All patients were able to achieve oral intake, but 3 patients required feeding tube support. In conclusion, postoperative systemic complications during the early postoperative period were considered to be acceptable, although wound complications such as tracheal necrosis and anastomotic leakage were commonly observed. Therefore, this minimally invasive procedure might help reduce mortality and morbidity in patients requiring TLPE with gastric pull-up reconstruction.
Rights: The final publication is available at www.springerlink.com
Type: article (author version)
URI: http://hdl.handle.net/2115/63391
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 本間 明宏

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