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Total laryngopharyngoesophagectomy with gastric transposition reconstruction: review of long-term swallowing outcomes

Published online by Cambridge University Press:  19 May 2008

A M Kelly ,
M J Drinnan ,
L Savy  and
D J Howard
A M Kelly*
Affiliation:
Head and Neck Centre, University College Hospital London, London, UK
M J Drinnan
Affiliation:
Regional Medical Physics Department, Freeman Hospital, Newcastle upon Tyne, UK
L Savy
Affiliation:
Department of Radiology, The Royal Free Hospital, London, UK
D J Howard
Affiliation:
Ear, Nose and Throat Department, Charing Cross Hospital, London, UK
*
Address for correspondence: Ms Annette Kelly, Head and Neck Centre, 1st Floor East, 250 Euston Road, London NW1 2PG, UK. Fax: +44 (0)20 7380 6952 E-mail: [email protected]
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Abstract

Aim:

The aim of this review was to examine long-term swallowing and eating outcomes following laryngopharyngoesophagectomy with gastric pull-up reconstruction.

Methods:

Ten patients underwent clinical examination and completed the performance status scale for head and neck questionnaire and also a gastric pull-up swallowing questionnaire designed for this review. Nine of the 10 patients underwent videofluoroscopic examination of swallowing.

Results:

One patient had a stricture at the orogastric anastomosis, and one patient had bilateral tongue immobility secondary to XIIth nerve palsies. Eight participants reported eating a normal diet, and five reported not limiting their eating environment. Regurgitation, slower eating and reduced capacity were the most common functional limitations.

Conclusions:

These results support previous opinions that the gastric pull-up procedure has good swallowing outcomes, and indicate that such outcomes continue in the long term.

Keywords

Hypopharyngeal NeoplasmsGastric TranspositionDeglutitionDeglutition Disorders
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 12 , December 2008 , pp. 1354 - 1359
Copyright
Copyright © JLO (1984) Limited 2008

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References

1Stepnick, DW, Hayden, RE. Options for reconstruction of the pharyngoesophageal defect. Otolaryngol Clin North Am 1994;27:1151–8CrossRefGoogle ScholarPubMed
2Haller, JR. Concepts in pharyngoesophageal reconstruction. Otolaryngol Clin North Am 1997;30:655–61CrossRefGoogle ScholarPubMed
3De Vries, EJ, Stein, DW, Johnson, JT, Wagner, RL, Schusterman, MA, Myers, EN et al. Hypopharyngeal reconstruction: a comparison of two alternatives. Laryngoscope 1989;99:614–17CrossRefGoogle ScholarPubMed
4Fredrickson, JM, Wagenfeld, DJ, Pearson, G. Gastric pull-up vs deltopectoral flap for reconstruction of the cervical esophagus. Arch Otolaryngol 1981;107:613–16Google Scholar
5Benazzo, M, Occhini, A, Rossi, V, Aresi, G, Alessiani, M. Jejunum free flap in hypopharynx reconstruction: case series. BMC Cancer 2002;2:13–18Google Scholar
6Pesko, P, Sabljak, P, Bjelovic, M, Stojakov, D, Simic, A, Nenadic, B et al. Surgical treatment and clinical course of patients with hypopharyngeal carcinoma. Dis Esophagus 2006;19:248–53Google Scholar
7Shenoy, RK, Pai, SU, Rajan, N. Stomach as a conduit for esophagus – a study of 105 cases. Indian J Gastroenterol 1996;15:52–4Google ScholarPubMed
8Smith, DF, Ott, DJ, McGuirt, WF, Albertson, DA, Chen, MYM, Gelfand, DW. Free jejunal grafts of the pharynx: surgical methods, complications, and radiographic evaluation. Dysphagia 1999;14:176–82CrossRefGoogle ScholarPubMed
9Harrison, DFN, Thompson, AE. Pharyngolaryngoesophagectomy with pharyngogastric anastomosis for cancer of the hypopharynx: review of 101 operations. Head Neck Surg 1986;8:418–28Google Scholar
10Shah, JP, Shemen, L, Spiro, RH, Strong, EW. Selecting variants in pharyngeal reconstruction. Ann Otol Rhinol Laryngol 1984;93:318–21CrossRefGoogle ScholarPubMed
11Disa, JJ, Cordeiro, PG. Reconstruction of the hypopharynx and cervical esophagus. Clin Plast Surg 2001;28:349–60CrossRefGoogle ScholarPubMed
12Hartley, BEJ, Bottrill, ID, Howard, DJ. A third decade's experience with the gastric pull-up operation for hypopharyngeal carcinoma: changing patterns of use. J Laryngol Otol 1999;113:241–3Google Scholar
13Schusterman, MA, Shestak, K, de Vries, EJ, Swartz, W, Jones, N, Johnson, J et al. Reconstruction of the cervical esophagus: free jejunal transfer versus gastric pull-up. Plast Reconstr Surg 1990;85:16–21CrossRefGoogle ScholarPubMed
14Missotten, FEM. Historical review of pharyngo-oesophageal reconstruction after resection for carcinoma of pharynx and cervical oesophagus. Clin Otolaryngol 1983;8:345–62Google ScholarPubMed
15Carlson, GW, Schusterman, MA, Guillamondegui, OM. Total reconstruction of the hypopharynx and cervical esophagus: a 20-year experience. Ann Plast Surg 1992;29:408–12CrossRefGoogle Scholar
16Schechter, GL, Baker, JW, Gilbert, DA. Functional evaluation of pharyngoesophageal reconstructive techniques. Arch Otolaryngol Head Neck Surg 1987;113:40–4CrossRefGoogle ScholarPubMed
17List, MA, Ritter-Sterr, C, Lansky, SB. A performance status scale for head and neck cancer patients. Cancer 1990;66:564–93.0.CO;2-D>CrossRefGoogle ScholarPubMed
18Rademaker, AW, Pauloski, BR, Logemann, JA, Shanahan, TK. Oropharyngeal swallow efficiency as a representative measure of swallowing function. J Speech Hear Res 1994;37:314–25Google Scholar
19McConnel, FMS, Hester, TR, Mendelsohn, MS, Logemann, JA. Manofluorography of deglutition after total laryngopharyngectomy. Plast Reconstr Surg 1988;81:346–51CrossRefGoogle ScholarPubMed