A multi-institutional study of reconstruction for laryngopharyngoesophagectomy

There is no standard reconstructive technique for cancer ablation in head and neck lesions. The wide variety of reconstructive techniques results in big differences in outcomes among each institution, so we carried out a multi-institutional study of reconstructive techniques, and investigated the outcomes for 10 years. In order to standardize the range of ablation, only patients who had a reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal cancer were included in this study. 764 patients were enrolled, of whom 715 patients (93.7%) were reconstructed with jejunum. There were differences among each institution's situation regarding the ratio of preoperative radiation and chemotherapy, total operation time, total volume of bleeding, ratio of abscess formation and fistula formation, duration of fast and hospital stay after operation. There was a correlation between long operation time and much bleeding. There was also a correlation between a large number of operations and short operation time. There was no correlation between the use of PGE1 and the risk of thrombosis. Preoperative radiation delayed wound healing significantly. We studied a multivariate analysis on each factor. The use of penrose drain and long operation time were significant risk factors of abscess or fistula formation. Based on these results, we would like to standardize reconstructive technique. This research was supported by a Grant-in-Aid for Cancer Research (grant 17-15) from the Ministry of Health and Welfare of Japan.