期刊
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
卷 28, 期 3, 页码 205-209出版社
WILEY
DOI: 10.1002/hed.20330
关键词
jejunal interposition; jejunal autograft; stricture; hypopharyngeal cancer; pharyngolaryngectomy
Background. Free jejunal interposition has been one of the standard reconstructive options for patients undergoing total laryngopharyngoesophagectomy. Tracheoesophageal puncture (TEP) done primarily is a well-accepted means of voice restoration. The rapid recovery of swallowing and communication in patients who have advanced cancer of the upper aerodigestive tract is a valid goal. The objective of this study was to evaluate the functionality and complications of primary TEP in patients with a free jejunal interposition graft. Methods. Twenty-four consecutive patients who had free jejunal interposition were studied. Thirteen of these patients had a primary TER Stricture was assessed through barium swallow, laryngoscopy, and CT scan. Results. A statistically significant greater number of patients had stricture develop after primary TEP (p < .0325). All these patients had stricture develop at the distal anastomosis. These patients also tended to have a poorer quality of diet. Moreover, speech with a TEP prosthesis in patients with a free jejunal interposition was less intelligible and functional than speech with a TEP prosthesis after simple laryngectomy. Conclusions. This article recognizes an increased incidence of stricture formation after primary TEP as compared with non-TEP in patients undergoing pharyngolaryngectomy with free jejunal interposition. The morbidity and possible etiology of this complication are discussed. This clinical data have been translated into a change in clinical practice. (c) 2005 Wiley Periodicals, Inc.
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