下咽頭・頸部食道癌に対する遊離空腸再建法と胃管再建法の比較検討

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  • The comparative study of a recostruction with gastric tube and free jejunal autograft for pharynx and/or cervical esophageal carcinoma.
  • 下咽頭・頚部食道癌に対する遊離空腸再建法と胃管再建法の比較検討

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Two reconstructive methods of operating on the pharynx and/or cervical esophagus were compared. The patients were divided into a reconstructive group of 7 cases (Gastric group) and a group of 14 cases with a free jejunal autograft without dissection of the mediastinal lymph nodes (FJA group). In the FJA group, complication in the respiratory system and anastomotic leakage did not occur, in contrast with the Gastric group in which there were 2 cases of respiratory disorders and 2 cases of anastomotic leakage. Mediastinal lymph node metastases was not seen in the Gastric group, but cervical paraesophageal lymph node metastases were found in 57.1% of the Gastric group and in 42.9% of the FJA group. These findings indicate that we should placed great importance on the dissection of the neck lymph nodes. In the patients with distant metastases, mediastinal lymph node metastases were found. Anastomotic stenosis and/or thrombus formation in a nutrient artery of FJA were not revealed by common carotid arteriography after the operation. The patient who survived the longest in the Gastric group survived 62 months and died of recurrence in the lung. In the FJA group, two patients have survived 5 years more. A significant difference in survival tme was not seen between the two groups. We emphasize that reconstruction with FJA is safe and benefical, especially in high-risk cases.

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