Pharynx and upper third of esophagus resection with laryngeal preservation in case of esophageal entrance tumor

Esophageal entrance cancer is often detected in locally advanced or advanced stage III–IV in 70–80% of patients, when a spread to the laryngopharynx and / or larynx does exist. The disease is characterized by aggressiveness and a high incidence of metastases. Given the anatomical complexity of this zone (the intersection of the esophagus and respiratory tracts, complex reflex mechanisms), most authors consider laryngopharyngectomy with circular resection of the pharynx and esophagus as the only method of surgical treatment for this category of patients. Currently, the literature describes various ways of the alimentary tract restoration (flaps with axial blood supply, use of visceral grafts-segments – the gut or stomach). But the problem of speech preservation in this category of patients is of extreme importance and relevance. There are several ways of voice function restoration in patients after laryngopharyngectomy with voice prostheses, but the quality of speech is not so high, since the pharyngeal esophagus segment is removed, and the bowel folds are not capable of vibrating well. We have developed and tested a method for performing an extensive resection of the pharynx and cervical esophagus in a patient with esophageal entrance cancer. At the same time, it was possible to restore the esophagus canal due to a small intestine transplant on microvascular anastomoses, to preserve the larynx and to ensure a high quality of life for the patient.

Key words: esophageal canal cancer, laryngopharyngeal cancer, larynx preservation, restoration of the esophagus canal for resection of pharynx and esophagus.

Authors declare no conflict of interests for this article.

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For citations: Kononets P.V., Novozhilova E.N., Matveev D.A., Chumakov I.F., Sorokoletov A.V., Stroyakovsky D.L., Shivilova M.Yu., Kanner D.Yu. Pharynx and upper third of esophagus resection with laryngeal preservation in case of esophageal entrance tumor. Golova I Sheya Head and neck Russian Journal. 2018;6(2):35–41 (in Russian).

The authors are responsible for the originality of the presented data and the ability to publish illustrative materialtables, figures, photos of patients.