[The advanced hypopharyngeal cancers surgery treatment complications]

Abstract

Introduction: Hypopharynx is the anatomical region created by strictly functionally connected regions: two pyriform sinuses, retrocricoid region and the posterior pharyngeal wall on its level. Hypopharyngeal Cancer is in 95% planoepithelial carcinoma, it constitute about 5-10% of all malignant tumors of the upper part of digestive tract and the respiratory system. Occult early symptoms make it advanced stages detectible. It easily spreads in to surrounding anatomical structures such as: larynx, oral cavity, oropharynx, esophagus, prevertebral space. It gives relatively quick and common metastases to lymph nodes (opposed or both sites).

Aim: The aim of our study is to analyze the complications of the advanced hypopharyngeal tumor surgery.

Material and methods: Material was 53 patients treated for advanced hypopharyngeal cancer (or hypopharyngeal cancer with larynx and cervical part of esophagus involved), in Otolaryngology Clinic, Medical University of Warsaw, between 1999 and 2010. We performed the circular removal of hypopharynx, cervical part of esophagus and larynx with concomitant digestive tract reconstruction by autotransplantation of the jejunum (41 cases) or the ileocecal segment (12 cases). In most cases surgery was extended to lymph nodes removal.

Conclusion: In our group of patients we had complications such as: Intraoperative complications of surgery - the intestine transplant ischemia. Early post operative complications - transplant ischemia, salivary fistula, hematoma of postoperative cavity (without necrosis of the transplant), massive arterial anastomosis bleeding, and wound infection. Late postoperative complications - late salivary fistula, tracheostomy stenosis, local tumor recurrence, spread of the cancer and swallowing disorder. The different complications were very uncommon.