A Prospective Study Comparing Laparoscopic vs. Conventional Stomach Pull Up in Total Pharyngo-Laryngo-Esophagectomy for Post Cricoid Cancer.

B V Prakash ,Shivaji Sharma,Saseendran Shruthi,Ali Zaid Anwar ,M G Abhishek

doi:10.3390/clinpract11020025

B V Prakash , Shivaji Sharma + Show 3 more

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https://doi.org/10.3390/clinpract11020025

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Abstract

The aim of this study is to compare laparoscopic and conventional techniques following Total Pharyngo-laryngo-esophagectomy (TPLE) with respect to perioperative morbidity and mortality and postoperative recovery in post cricoid cancer patients. This is a prospective study, which was undertaken in Gujrat Cancer Research Institute (GCRI) in the period of July 2007 to March 2010. Fifteen consecutive patients who underwent laparoscopic TPLE were compared to that of 18 consecutive patients who underwent open TPLE. Laparoscopic and open TPLE procedure were compared with respect to patient characteristics, intra operative and complications present. The average duration was observed to be 3.5 h in the MIS (Minimally Invasive Group) group and was 5.3 h in the open group. The average blood loss was 300 mL in the MIS group and 500 mL in the open group. Average duration of the hospital stay in the MIS group was 13 days and 16 days in the open group. In the MIS group, one patient (6.7%) had a pneumonic complication and two patients (13%) had wound complications. In the open group, six patients (33%) had pneumonic consolidation and four patients (22%) had wound infections. In both groups, one patient each suffered mortality. Laparoscopic TPLE has been found to be much safer with less morbidity as compared with open surgery.

Highlights

Post cricoid cancer is more common in women worldwide and usually associated with iron deficiency anemia and the Plummer-Vinson syndrome
India as well as France have the highest rates of post cricoid cancers throughout the world [1]
Hypopharyngeal cancers usually occur in low socioeconomic classes

Summary

Introduction

Post cricoid cancer is more common in women worldwide and usually associated with iron deficiency anemia and the Plummer-Vinson syndrome. India as well as France have the highest rates of post cricoid cancers throughout the world (annual incidence of 8–15 per 10,000) [1]. Hypopharyngeal cancers usually occur in low socioeconomic classes. Most of the patients usually present late with advanced disease (T3–T4). Prognosis of advanced hypopharyngeal cancer is poor. The prognosis is generally dismal with a mean five-year survival rate of 18–35% (Pingree & Axon) [2,3]. The standard of care is surgery followed by adjuvant radiotherapy. This treatment helps us achieve relief of dysphagia, which is the main symptom, and requires attaining the best possible survival

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