Pharyngolaryngectomy with extrathoracic esophagectomy

Area of Science:

• Oncology
• Surgical Oncology
• Head and Neck Cancer

Background:

• Squamous cell carcinoma of the hypopharynx presents a significant surgical challenge.
• Extensive submucosal spread into the cervical esophagus is a common complication.
• Adequate distal margin clearance is critical for successful oncologic outcomes.

Purpose of the Study:

• To evaluate the efficacy of radical esophageal excision in managing hypopharyngeal squamous cell carcinoma.
• To assess the outcomes of total pharyngolaryngectomy and extrathoracic esophagectomy with primary pharyngogastric anastomosis.
• To determine the necessity of extensive esophageal resection for achieving adequate distal clearance.

Main Methods:

• Retrospective analysis of fourteen patients with hypopharyngeal squamous cell carcinoma.
• Surgical procedure included total pharyngolaryngectomy and extrathoracic esophagectomy.
• Primary pharyngogastric anastomosis was performed in all cases.
• Histological examination of resected specimens to assess submucosal spread.

Main Results:

• Histological examination revealed extensive submucosal spread into the cervical esophagus in all patients.
• Radical excision of the esophagus was required for adequate distal clearance in all cases.
• Primary pharyngogastric anastomosis was successfully achieved.

Conclusions:

• Radical esophageal excision is a necessary component in the surgical management of hypopharyngeal squamous cell carcinoma with cervical esophageal involvement.
• This approach ensures adequate oncologic margins, potentially improving patient outcomes.
• Total pharyngolaryngectomy and extrathoracic esophagectomy with pharyngogastric anastomosis is a viable reconstructive option.