Surgical technique for the prevention of tracheal necrosis following total pharyngolaryngectomy.

Akihisa Tanaka,Ichiro Ota,Takashi Masui,Hiroshi Akioka,Hirokazu Uemura,Shiori Adachi,Tadashi Kitahara,Takahiro Kimura

doi:10.3892/mi.2021.18

Abstract

Total pharyngolaryngectomy with cervical esophagectomy (TPLCE) is an invasive procedure with various post-operative complications. Tracheal necrosis (TRN) is a fatal complication of TPLCE. The present study aimed to identify a surgical technique which may be used to prevent TRN. The post-operative complications of 48 patients who underwent TPLCE from January, 2010 to December, 2019 were retrospectively investigated. The incidence of TRN was examined and measures against TRN were reviewed. The results revealed that 3 patients (6%) experienced TRN within 1 week following surgery. In addition, 2 patients required the surgical debridement of the necrotic tissue and tracheoplasty. The other patient underwent conservative treatment. Stomal recurrence developed in 1 patient (2%). On the whole, the present study demonstrates that the incidence of TRN following TPLCE is lower than that observed in previous reports, and only one stomal recurrence was reported. Preserving the blood supply to the trachea is essential for the prevention of TRN. The eight surgical processes used herein effectively preserved the blood supply. Further investigations however, are necessary in order to confirm the present findings and to ensure effective measures are found with which to prevent TRN following TPLCE.

Highlights

Head and neck cancer, which occurs in the oropharynx, hypo‐ pharynx, larynx, or cervical esophagus, is often diagnosed at Abbreviations: total pharyngolaryngectomy with cervical esopha‐ gectomy (TPLCE), total pharyngolaryngectomy with cervical esophagectomy; TRN, tracheal necrosis; ITA, inferior thyroid arteryKey words: tracheal necrosis, total pharyngolaryngectomy, head and neck cancer, inferior thyroid artery, surgical processes an advanced stage
Head and neck cancer, which occurs in the oropharynx, hypo‐ pharynx, larynx, or cervical esophagus, is often diagnosed at Correspondence to: Dr Akihisa Tanaka, Department of Otolaryngology‐Head and Neck Surgery, Nara Medical University, 840 Shijo‐cho, Kashihara, Nara 634‐8522, Japan E‐mail: takihisa16@naramed‐u.ac.jp
The present study aimed to identify a technique that may be used to prevent TRN following TPLCE and describes eight surgical processes that may be used for this purpose

Summary

Introduction

Head and neck cancer, which occurs in the oropharynx, hypo‐ pharynx, larynx, or cervical esophagus, is often diagnosed at Abbreviations: TPLCE, total pharyngolaryngectomy with cervical esophagectomy; TRN, tracheal necrosis; ITA, inferior thyroid artery. The present study aimed to identify a technique that may be used to prevent TRN following TPLCE and describes eight surgical processes that may be used for this purpose

Methods

Results

Conclusion