Rationality analysis of reconstruction of digestive tract after resection of the lesions of hypopharynx and cervical esophagus

Liu Zhibin; Chen Yanshan; Yang Shengrong

Abstract：ObjectiveAnalysis the upper digestive tract reconstruction is reasonable after resection of hypo-pharyngeal and cervical esophageal cancer.Methods 54 hypopharyngeal and cervical esophageal cancer patients were retrospectively analyzed from May 2009 to April 2015 in our hospital from, including 11 female,43 male. In 48 patients with hypopharyngeal cancer included 3 postcricoid carcinoma,35 pyriform sinus carcinoma,5 posterior wall of pharynx carcinoma;5 cervical esophageal carcinoma. According to AJCC,3 cases of stage I,9 cases of stage II,20 cases of stage III(including 1 case of T1N1M0,2 T2N1M0,6 T3N0M0,11 T3N1M0)nineteen IV(including 1 case of T1N2M0,2 T2N2M0,7 T3N2M0,2 T3N3M0, 3 T4N0M0,1 T4N1M0,3 T4N2M0),all patients were treated by surgical treatment.Results66.66%(36/54)pa-tients were performed pedicled pectoralis major muscle flap, 12.96%(7/54)patients with gastric pull-up esophageal recon-struction,3.70%(2/54)patients for free flap surgery,1.85%(1/54)with free jejunal interposition,1.85%(1/54)for colon and generation feed tube surgery,3.70%(2/54)of the patients with composite flap,3.70%(2/54)in patients with hypopharyngeal mucosa and 5.55%(3/54)in patients with laryngotracheal flap reconstruction. The success rate of early swallowing was 96.29%(52/54),postoperative14.81%(8/54)of the patients with skin pharyngeal fistula. Accounted for 3.70%(2/54)patients showed off all or part of the graft, a total of 16.66%(9/54)patients to restore or reconstruct the pronunciation function,5.55%(3/54)patients who have pulled out the catheter within 1 months after operation in 1.85%(1/54)of the patients died.ConclusionHypopharyngeal and cervical esophageal carcinoma resection after digestive tract reconstruction is reliable,effective method,patients from the actual situation of making for the selection and appli-cation,if the patient belongs to the upper thoracic esophageal carcinoma can be selected transhiatal esophagectomy resec-tion,lifting the stomach be cervical food tube anastomosis were treated,with respect to the muscle flap in the hypophar-ynx and larynx resection intraoperative use of free tissue flap in the reconstruction of the effect is more significant,In this way can we guarantee the postoperative patients remain relatively normal digestive functions,easy to survival.