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Esophagus

, Volume 16, Issue 4, pp 382–385 | Cite as

Ivor–Lewis esophagectomy for patients with squamous cell carcinoma of the thoracic esophagus with a history of total pharyngolaryngectomy

  • Keita Takahashi
  • Shinji MineEmail author
  • Ryotaro Kozuki
  • Tasuku Toihata
  • Akihiko Okamura
  • Yu Imamura
  • Masayuki Watanabe
Original Article
  • 46 Downloads

Abstract

Background

Synchronous or metachronous esophageal, and head and neck cancers are often observed, and we occasionally encounter esophageal cancer cases with a past history of total pharyngolaryngectomy (TPL) for head and neck cancers. Total esophagectomy after TPL may impair blood supply to the trachea and may cause tracheal necrosis. Meanwhile, Ivor–Lewis esophagectomy can prevent the above-mentioned risks, but there is a concern about an anastomosis with the remnant upper esophagus that lost blood supply after two surgical procedures. The surgical outcomes of Ivor–Lewis esophagectomy after TPL remain unclear. Therefore, we investigated the surgical outcomes.

Methods

This study included patients who underwent Ivor–Lewis esophagectomy for esophageal cancer with a history of TPL at our institution between 2005 and 2017. We retrospectively investigated the patients’ background characteristics and short-term surgical outcomes.

Results

Twelve consecutive patients (8 men and 4 women) were included in this study. The median period between TPL and esophagectomy was 32 months (range 2–185 months). All patients underwent esophagectomy via right open thoracotomy and reconstruction using a gastric tube with intrathoracic anastomosis. Although the esophagogastric anastomosis was made on the remnant upper esophagus, which had already lost blood supply from the inferior thyroid artery, there was no case of anastomotic leakage or esophageal necrosis, and hospital mortality was not observed.

Conclusion

Ivor–Lewis esophagectomy for patients with a history of TPL is a safe procedure, which can prevent severe complications including anastomotic leakage or tracheal necrosis.

Keywords

Esophageal squamous cell carcinoma (ESCC) Ivor–Lewis esophagectomy Total pharyngolaryngectomy (TPL) 

Notes

Compliance with ethical standards

Ethical Statement

This study was approved by the Cancer Institute Hospital Clinical Research Review Board. The need for informed consent was waived because of the retrospective design of the study.

Conflict of interest

The authors have no conflicts of interest.

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Copyright information

© The Japan Esophageal Society and Springer 2019

Authors and Affiliations

  1. 1.Department of Gastroenterological SurgeryThe Cancer Institute Hospital of Japanese Foundation for Cancer ResearchTokyoJapan

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