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Ann Thorac Surg 1994;57:112-117
© 1994 The Society of Thoracic Surgeons
Department of Surgery (1), Kanazawa University School of Medicine, Kanazawa, and Department of Surgery (I), Toyama Medical and Pharmaceutical University, Toyama, Japan
Accepted for publication February 11, 1993.
* Address reprint requests to Dr Omura, Department of Surgery (I), Kanazawa University School of Medicine, Takaramachi 13-1, Kanazawa 920, Japan.
Twenty-four patients with hypopharyngeal or cervical esophageal carcinoma were treated surgically. All had squamous cell carcinoma, and none had intrathorack lymph node involvement by preoperative computed tomography. Endoscopy in 18 patients confirmed there was no intramural spread into the thoracic esophagus. The patients underwent pharyngolaryngoesophagectomy and bilateral modified radical neck dissection. Reconstruction of the cervical esophagus was performed with transplantation of a free jejunal autograft. Postoperative complications included anastomotic leak in 2 patients (8.3%), wound infection in 3 (12.5%), and intussusception in 4 (16.7%). Reconstruction of the cervical esophagus was successful in 23 (95.8%) of the 24 patients. The operative mortality rate was 4.2%, and the 5-year survival rate was 39.7%. We emphasize that pharyngolaryngoesophagectomy followed by transplantation of a free jejunal graft is suitable for cervical esophageal carcinoma or hypopharyngeal carcinoma when the disease is limited to the cervical region.
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