Reconstructive Surgery Using Stomach for Cancer of the Hypopharynx and Cervical Esophagus

Hiroko Ide

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College

From January 1976 to September 1990, 64 carcinomas of the hypopharynx and cervical esophagus were resected in our department. Total esophagectomy was performed in 39 patients (61%), whose average age was 64 years and who had mainly Ce-CeIu carcinoma. From the aspect of curability, there was no difference between partial and total esophagectomy. Concerning the organs for substitution, stomach was used in 92% of the total esophagectomies and 56% of all resections. On the other hand, free jejunal graft after partial resection was used in 38% of all cases. The rate of postoperative complications when stomach was used after blunt dissection was 31%, which is bit higher than for free jejunal grafts (18%). In the resected specimen in total esophagectomy, the rate or remnant cancer with a resected edge is low, even 0% an the anal site. Thirty-three percent of the patients receiving total esophagectomy had multiple cancers. The 5-year survival rate after curative resection pharyngogastrostomy with blunt dissection was 41.7%, and that after free jejunal graft was 26.2%. Because of the high incidence of synchronous intrathoracic carcinoma and carcinoma of the cervical esophagus and hypopharyns, reconstrucion by stomach with blunt dissection is a useful method requiring no special technics of microvascular anastomosis except for patients with stomach disease.

Key words
cancer of the hypopharynx and carvical esophagus, blunt dissection without thoracotomy, reconstration with stomach

Reprint requests
Hiroko Ide Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical College
8-1 Kawadacho, Sinjuku-ku, 162 JAPAN

Accepted
April 17, 1991

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