eISSN: 1897-4309
ISSN: 1428-2526
Contemporary Oncology/Współczesna Onkologia
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1/2021
vol. 25
 
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abstract:
Original paper

Jejunal and ileocolic free flaps for digestive tract reconstruction following pharyngo-laryngo-oesophagectomy – 30 years of single-centre experience

Ewa Osuch-Wójcikiewicz
1
,
Daniel Majszyk
1
,
Antoni Bruzgielewicz
1
,
Tadeusz Grochowiecki
2
,
Sławomir Nazarewski
2
,
Piotr Chęciński
1
,
Kazimierz Niemczyk
1

  1. Department of Otorhinolaryngology Head and Neck Surgery, Medical University in Warsaw, Warsaw, Poland
  2. Department of General, Vascular and Transplant Surgery, Medical University in Warsaw, Warsaw, Poland
Contemp Oncol (Pozn) 2021; 25 (1): 28-32
DOI: https://doi.org/10.5114/wo.2021.105074
Online publish date: 2021/04/15
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Introduction
Hypopharyngeal cancer accounts for 3–5% of all squamous-cell carcinoma (SCC) of the head and neck and has one of the worst prognoses. The aim of the study was to evaluate oncologic and functional treatment outcomes in patients with T3-T4a squamous cell hypopharyngeal and laryngeal cancer.

Material and methods
Retrospective analysis of the material from one treatment site included 90 patients (81 male, 9 female) who had undergone surgery between 1986 and 2010. Their mean age was 55.06 years (range 36–75).

Results
TNM (T – tumour, N – node, M – metastasis) staging assessment was feasible in 70 treatment-naïve patients (77.78%): 57 (63.33%) were classified to stage T4a, and 13 were classified to T3 (14.44%). Cervical lymphadenopathy was observed in 53 (63.3%) patients; in 44 patients (48.89%) postoperative histopathology confirmed metastatic disease. G2 or G3 SCC was detected in 80% of patients. All patients underwent laryngopharyngoesophagectomy (LPE). Digestive tract reconstruction was performed using one of two methods: jejunal autograft (JA) in 79 patients (87.78 %) – Group A or ileocolic autograft (IA) in 11 patients (12.22%) – Group B. Comparative statistical analysis of both groups showed statistically significant differences only for substitute speech production. The mean survival time of patients from both groups was 2.21 years after reconstruction surgery.

Conclusions
JA or IA for digestive tract reconstruction in patients after LPE are burdened with high risk of complications but offer patients the chance of a normal oral diet shortly after surgery. Ileocolic autograft enables rapid production of substitute speech.

keywords:

hypopharynx cancer, digestive tract reconstruction, jejunal autograft, ileocolic autograft
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