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Published on: December 1, 2023
Functional outcomes following total laryngopharyngectomy
Tim A Iseli1, Nicholas J M Agar, Catherine Dunemann
1Department of Otolaryngology, Head and Neck Surgery, St Vincent's Hospital, Melbourne, Victoria, Australia. iselitim@hotmail.com
ANZ Journal of Surgery
|October 13, 2007
Summary
Laryngopharyngectomy is a gold standard treatment for advanced hypopharyngeal and esophageal tumors. Despite technical demands, selected patients show low mortality and acceptable functional outcomes with careful postoperative care.
Area of Science:
- Oncology
- Surgical Oncology
- Otorhinolaryngology
Background:
- Laryngopharyngectomy remains a gold standard for advanced hypopharyngeal and upper esophageal tumors.
- Improved perioperative care and reconstruction techniques have enhanced outcomes.
- It is also used as salvage treatment after failed chemoradiotherapy.
Purpose of the Study:
- To evaluate the outcomes of total laryngopharyngectomy in patients with locally advanced hypopharyngeal and upper esophageal tumors.
- To assess functional results, including oral alimentation and verbal communication.
- To analyze survival rates and causes of mortality.
Main Methods:
- Prospective recording of 18 patients undergoing total laryngopharyngectomy between July 2001 and July 2006.
- Data collection included demographics and functional outcomes.
- Reconstruction methods involved free jejunal interposition or gastric pull-up.
Main Results:
- Patients underwent reconstruction via free jejunal interposition (50%) or gastric pull-up (38.9%).
- Complications included fistulas (33%) and strictures (33%).
- Overall, 88.9% of jejunal and 100% of gastric pull-ups tolerated oral alimentation, and 100% achieved verbal communication.
Conclusions:
- Surgical treatment for hypopharyngeal and cervical esophageal neoplasms is complex, requiring meticulous postoperative management.
- Laryngopharyngectomy can yield acceptable functional and survival results in selected patients.
- Despite a poor tumor prognosis, selected patients benefit from low mortality rates.
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