DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20181862

Total pharyngolaryngectomy with laparoscopic transhiatal oesophagectomy with gastric pull-up: a study of 13 cases

Shailesh S. Puntambekar, Priyesh S. Halgaonkar

Abstract


Background: Post cricoid cancers are known to be treated with total pharyngo-laryngo-oesophagectomy (TPLO) with several reconstructive procedures described. This study aims at clinical symptoms in patients having hypopharyngeal cancer who underwent total pharyngo-laryngectomy with laparoscopic transhiatal oesophagectomy (TPLO) with gastric pull-up (GPU).

Methods: The clinical data of 13 patients undergoing TPLO with GPU during July 2013 to September 2017 were evaluated. All the patients had biopsy proven carcinoma. TPL was done and laparoscopic Transhiatal oesophagectomy was done and also the stomach was mobilized laparoscopically. The neostomach was delivered through posterior mediastinum and pharyngogastric anastomosis was done.  

Results: Only one patient (7%) had anastomotic stricture which required endoscopic dilatation, rest all the patients had no complications. So far they remain free of tumor recurrence or any other symptoms.

Conclusions: Laparoscopic GPU in a patient of TPLO should be the procedure of choice for maintaining the continuity of alimentary tract.


Keywords


Total pharyngo-laryngo-oesophagectomy, Laparoscopic gastric pull-up

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References


Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000;355(9208):949-55.

Kraus DH, Zelefsky MJ, Brock HA, Huo J, Harrison LB, Shah JP. Combined surgery and radiation therapy for squamous cell carcinoma of the hypopharynx. Otolaryngol Head Neck Surg. 1997;116:637–41.

Eckel HE, Staar S, Volling P, Sittel C, Damm M, Jungehuelsing M. Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results. Otolaryngol Head Neck Surg. 2001;124:561–9.

Chu PY, Wang LW, Chang SY. Surgical treatment of squamous cell carcinoma of the hypopharynx: analysis of treatment results, failure patterns, and prognostic factors. J Laryngol Otol. 2004;118:443–9.

Hypopharyngeal cancer overview. Updated on 19 December 2017 Available at https://emedicine. medscape.com/article/1375268-overview. Accessed on 3 January 2018.

Couch ME. Laryngopharyngectomy with reconstruction. Otolaryngologic Clin North Am. 2002;35:1097–114.

Turner GG. Excision of the thoracic oesophagus for carcinoma with reconstruction of an extrathoracic gullet. Lancet. 1933;2:1315-20.

Ong GB, Lee TC. Pharyngogastric anastomosis after esophagopharyngectomy for carcinoma of the hypopharynx and cervical esophagus. Br J Surg. 1960;48:193–200.

Spiro RH, Bains MS, Shah JP, Strong EW. Gastric transposition for head and neck cancer: a critical update. Am J Surg. 1991;162:348–52.

Harrison DF, Thompson AE. Pharyngolaryngoesophagectomy with pharyngogastric anastomosis for cancer of the hypopharynx: review of 101 operations. Head Neck Surg. 1986;8:418–28.

Dudhat SB, Mistry RC, Fakih AR. Complications following gastric transposition after total laryngo-pharyngectomy. Eur J Surg Oncol. 1999;25:82–5.

Shuangba H, Jingwu S, Yinfeng W, Yanming H, Qiuping L, Xianguang L, et al. Complication following gastric pull-up reconstruction for advanced hypopharyngeal or cervical esophageal carcinoma: a 20-year review in a Chinese institute. Am J Otolaryngol. 2011;32(4):275-8.

Homma A, Nakamaru Y, Hatakeyama H, Mizumachi T, Kano S, Furusawa J, et al. Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision. Eur Arch Otorhinolaryngol. 2015;272(11):3551-6.

Sreehariprasad AV, Krishnappa R, Chikaraddi BS, Veerendrakumar K. Gastric Pull Up Reconstruction After Pharyngo Laryngo Esophagectomy for Advanced Hypopharyngeal Cancer. Indian J Surg Oncol. 2012;3(1):4–7.

Ullah R, Bailie N, Kinsella J, Anikin V, Primrose WJ, Brooker DS. Pharyngo-laryngo-oesophagectomy and gastric pull-up for post-cricoid and cervical oesophageal squamous cell carcinoma. J Laryngol Otol. 2002;116(10):826-30.

Triboulet JP, Mariette C, Chevalier D, Amrouni H; Surgical Management of Carcinoma of Hypopharynx and Cervical Oesophagus. Arch Surg. 2001;136:1164-70.

Dağli S, Unsal EE, Arikan O, Ozdem C. Gastric pull-up in hypopharyngeal and cervical esophageal cancers. Kulak Burun BogazIhtis Derg. 2002;9(5):363-7.

Huscher C, Mingoli A, Mereu A, Sgarzini G. Pharyngolaryngo-Esophagectomy with Laparo-scopic Gastric Pull-Up: A Reappraisal for the Pharyngoesophageal Junction Cancer. Ann Surg Oncol. 2012;19(9):2980.