Laryngotracheal Flap による下咽頭癌切除後再建

Abstract

We used hemilaryngotracheal tissue without tumor involvement as a laryngotracheal flap (LTF) for immediate repair of a pharyngoesophageal defect following resection for hypopharyngeal cancer. Five cases of lateralized advanced hypopharyngeal cancer were treated in our department. The median age was 82 years, ranging from 64 to 90 years. Four tumors were T3 stage, and the other was T2. A pharyngocutaneous fistula developed in one patient. The postoperative swallowing function was satisfactory, but one patient developed difficulty in eating a normal diet, because of pharyngoesophageal stenosis at 7 months after chemoradiotherapy. During the follow-up period, there was no locoregional recurrence. One patient had lung metastasis, and died of the disease. One patient died of another cause. Three patients are alive without evidence of the disease. Reconstruction of the hypopharynx with an LTF is a minimally invasive method compared with the radial forearm free flap and free jejunal flap. For selected cases of advanced hypopharyngeal cancer, this method would be one of the choices to reconstruct the pharyngoesophageal defect.