Gastric pull-up in hypopharyngeal and cervical esophageal cancers

Year 2002, Volume: 9 Issue: 5, 363 - 367, 10.10.2002

E. Evrim Ünsal Şafak Dağlı Osman Arıkan Cafer Özdem

Abstract

Objectives: Gastric pull-up is a common technique in the reconstruction of gastrointestinal continuity follovving surgery for the primary esophageal and hypopharyngeal tumors with involvement of the esophagus. We evaluated the results of surgery in patients with cervical esophageal and hypopharyngeal cancers.Pati ents and Methods: Eleven patients 4 women, 7 men; mean age 46 years; range 18 to 70 years unden/vent surgery for hypopharyngeal and cervical esophageal epidermoid carcinoma. Surgery included pharyngolaryngoesophagec- tomy, subtotal thyroidectomy, and gastric pull-up in ali patients. İn addition, nine patients had radical neck dissection on the involved side and modified radical neck dissec- tion on the contralateral side. One patient had bilateral rad­ical neck dissection. Patients who were alive were follovved- up for a mean period of 27 months range 14 to 46 months .Results: The one-, two-, and three-year survival rates were 54% 6/11 , 36% 4/11 and 18% 2/11 , respectively. Three patients died from early postoperative complications, two from organ failure due to locoregional recurrence 7th month and to distant metastasis 11 th month .Conclusion: Despite the small size of the study, the results favor the use of gastric pull-up in selected patients with cervical esophageal and hypopharyngeal cancers.

Keywords

Carcinoma, squamous cell/surgery, esophageal neoplasms/surgery, esophagectomy, hypopharyngeal neoplasms/ surgery, laryngectomy, pharyngectomy, postoperative complications, prognosis, stomach/surgery/transplantation, survival rate

Hipofarenks ve servikal özofagus kanserlerinde gastrik pull-up

Abstract

Am a ç : Gastrik pull-up, primer özofagus ve özofagusa ya- yılan hipofarenks tümörlerinde, gastrointesinal sistemin devamlılığının sağlanmasında sık kullanılan bir rekonst- rüksiyon tekniğidir. Çalıflmamızda, hipofarenks ve servi- kal özofagus kanseri nedeniyle ameliyat edilen hastalar- da bu tekniğin sonuçları değerlendirildi. Hastalar ve Yöntemler: Hipofarenks ve servikal özofa- gus epidermoid kanseri nedeniyle ameliyat edilen 11 hasta ça- lıflmaya alındı. Tüm hastalara farengolarengoözofajek- tomi, subtotal tiroidektomi ve gastrik pull-up ameliyatı yapıldı. Aynı seansta, dokuz hastaya lezyon tarafına radikal boyun diseksiyonu, diğer tarafa modifiye radikal boyun diseksiyonu, bir hastaya da iki taraflı radikal bo- yun diseksiyonu uygulandı. Hayatta kalan hastalar or- talama 27 ay dağılım 14-46 ay süreyle izlendi. Bu l g u l a r : Sağkalım oranları bir yıl için %54 6/11 , iki yıl için %36 4/11 , üç yıl için %18 2/11 bulundu. Üç hasta ameliyat sonrasında geliflen komplikasyonlar, bir hasta lokorejyonel nüks 7. ay , biri de uzak metas- taza bağlı organ yetmezliği 11. ay nedeniyle yaflamı- nı yitirdi. Sonu ç : Sınırlı hasta sayısına rağmen, gastrik pull-up tek- niğinin uygun seçilmifl olgularda fonksiyonel sonuçları iyi olan, güvenilir bir rekonstrüksiyon yolu olduğunu düflünü- y o r u z

Keywords

Karsinom, skuamöz hücreli/cerrahi, özofajeal neoplazmlar/cerrahi, özofajektomi, hipofarenjeal neoplazmlar/cerrahi, larenjektomi, farenjektomi, ameliyat sonrası komplikasyon, prognoz, mide/cerrahi/transplantasyon, sağkalım oranı

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