Colonic Reconstruction Research Articles

Resectional Management of Airway Invasion by Thyroid Carcinoma

Invasion of the trachea by thyroid carcinoma is best managed by resection with airway reconstruction. Localized extension of tumor may also require esophageal resection or radical resection including laryngectomy with mediastinal tracheostomy. Twenty-two patients (12 with papillary, 3 with follicular, 4 with mixed papillary and follicular, and 3 with undifferentiated carcinoma) underwent resection—16 with airway reconstruction and 6 with cervicomediastinal en bloc resection with mediastinal tracheostomy. Eleven had prior thyroidectomy. Ten of those having airway restitution required cylindrical tracheal resection, 5 had resection of trachea with a portion of the larynx, and 1 had wedge resection. Three undergoing laryngotracheal resection also needed esophagectomy. Colon reconstruction was used. Fifteen of the 16 having airway reconstruction had good surgical results with speech preservation. One died of complications due to prior irradiation. One of 6 undergoing radical resection died postoperatively. Six of the 20 survivors died of recurrence in 1 2/3 to 9 years, and 2 others died of other diseases. Three who had known pulmonary metastases at the time of palliative operation are alive between 2 and 3 2/3 years postoperatively, and a fourth who has pulmonary metastases is alive 6 1/6 years later. Eight patients are alive without disease from 1/12 to 8 3/4 years. Only two patients had airway recurrence. Resection and primary reconstruction of the trachea invaded by carcinoma of the thyroid should be done in the absence of extensive metastases when technically feasible. It offers prolonged palliation, avoidance of suffocation due to bleeding or obstruction, and an opportunity for cure. In carefully selected patients with massive regional involvement, radical excision with laryngectomy and esophagectomy is also appropriate.

Left colon reconstruction of the pharynx after pharyngolaryngectomy.

Using pedicled left colon for reconstruction of the pharynx following resection for carcinoma, we were able to restore normal swallowing within three weeks in five of 11 patients with extensive disease. Since only one of these has been a long term survivor this represents very useful palliation as it is of paramount importance in these patients with short survival times to restore normal swallowing as early as possible.

Functional evaluation of the interposed colon as an esophageal substitute.

Five Rhesus monkeys and four human adults with colonic reconstruction of the esophagus have been studied by manometric, fluoroscopic and reflux tests. Transit through the graft is mainly under the influence of gravity. Infrequent colon contractions can be propulsive, and sequential haustral contractions give the appearance of peristalsis. The diaphragmatic hiatus and esophagocolic anastomosis are the sites of weak barriers to reflux which are readily overcome by abdominal compression and gastric distension. Esophageal peristalsis is necessary to return refluxed material and cricopharyngeus muscle is the final barrier to regurgitation.

Rupture of the trachea during laryngo-oesophagectomy.

AnaesthesiaVolume 29, Issue 4 p. 448-451 Free Access Rupture of the trachea during laryngo-oesophagectomy A. B. LOACH, A. B. LOACH A. B. Loach, MA, MB, BChir, FFARCS, Registrar, Nuffield Department of Anaesthetics, Radcliffe Infirmary, Oxford.Search for more papers by this author A. B. LOACH, A. B. LOACH A. B. Loach, MA, MB, BChir, FFARCS, Registrar, Nuffield Department of Anaesthetics, Radcliffe Infirmary, Oxford.Search for more papers by this author First published: July 1974 https://doi.org/10.1111/j.1365-2044.1974.tb00684.xCitations: 2AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Brain, R.H.F. & Reading, P.V. (1966) Colon transplantation into the pharynx and cervical oesophagus. British Journal of Surgery, 53, 933. 2 Fairman, H.D., Hadley, S.K.J. & John, H.T. (1964) Pharyngolaryngectomy and colonic reconstruction: a one-stage operation for cancer of the pharynx and cervical oesophagus. British Journal of Surgery, 51, 663. 3 Lees, W. (1967) Colonic replacement after pharyngolaryngectomy. British Journal of Surgery, 54, 541. 4 Coffin, S. (1955) Total laryngectomy: anaesthetic techniques. Anaesthesia, 10, 285. 5 Campkin, T.V. (1969) Anaesthesia for pharyngolaryngectomy and colon replacement. British Journal of Anaesthesia, 41, 1073. 6 Gorham, A.P., Baskett, P.J.F. & Clement, J.A. (1965) Anaesthesia for pharyngolaryngectomy with colonic replacement. Anaesthesia, 20, 279. 7 Condon, H.A. (1971) Anaesthesia for pharyngo-laryngo-oesophagectomy with pharyngo-gastros-tomy. British Journal of Anaesthesia, 43, 1061. 8 Ravagnan, R. (1968) La ventilazione separata dei polmoni a pressionu differenziate in re-animazione respiratoria. Anesthesia, Rianimazione, 9, 365. 9 Birkinshaw, K. (1971) A method for securing the airway during operations on the pharynx and trachea. Anaesthesia, 26, 84. Citing Literature Volume29, Issue4July 1974Pages 448-451 ReferencesRelatedInformation

Colonic reconstruction of the esophagus in infants and children: R. E. Gross and F. N. Firestone. Surgery 61:955–964, June 1967

Colonic reconstruction of the esophagus in infants and children: R. E. Gross and F. N. Firestone. Surgery 61:955–964, June 1967

Colonic reconstruction of the esophagus in infants and children.

Colonic reconstruction of the esophagus in infants and children.

PHARYNGOLARYNGECTOMY AND COLONIC RECONSTRUCTION. A ONE-STAGE OPERATION FOR CANCER OF THE PHARYNX AND CERVICAL OESOPHAGUS.

Journal Article Pharyngolaryngectomy and colonic reconstruction. A One-stage operation for cancer of the pharynx and cervical oesophagus Get access H D Fairman, H D Fairman United Bristol Hospitals Search for other works by this author on: Oxford Academic Google Scholar S K J Hadley, S K J Hadley United Bristol Hospitals Search for other works by this author on: Oxford Academic Google Scholar H T John H T John Department of Surgery, University of Bristol Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 51, Issue 9, September 1964, Pages 663–668, https://doi.org/10.1002/bjs.1800510905 Published: 06 December 2005