Cargando…

A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan

AIM: Digestive reconstruction after pharyngolaryngectomy with total esophagectomy (PLTE) remains challenging, with the optimal method remaining unclear. The current study aimed to clarify the short‐term outcomes after PLTE and determine the optimal digestive reconstruction method. METHODS: Based on...

Descripción completa

Detalles Bibliográficos
Autores principales: Okamura, Akihiko, Watanabe, Masayuki, Mukoyama, Nobuaki, Ota, Yoshihiro, Shiraishi, Osamu, Shimbashi, Wataru, Baba, Yoshifumi, Matsui, Hidetoshi, Shinomiya, Hirotaka, Sugimura, Keijiro, Morita, Masaru, Sakai, Makoto, Sato, Hiroshi, Shibata, Tomotaka, Nasu, Motomi, Matsumoto, Shuichi, Toh, Yasushi, Shiotani, Akihiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786680/
https://www.ncbi.nlm.nih.gov/pubmed/35106415
http://dx.doi.org/10.1002/ags3.12509
_version_ 1784639167419908096
author Okamura, Akihiko
Watanabe, Masayuki
Mukoyama, Nobuaki
Ota, Yoshihiro
Shiraishi, Osamu
Shimbashi, Wataru
Baba, Yoshifumi
Matsui, Hidetoshi
Shinomiya, Hirotaka
Sugimura, Keijiro
Morita, Masaru
Sakai, Makoto
Sato, Hiroshi
Shibata, Tomotaka
Nasu, Motomi
Matsumoto, Shuichi
Toh, Yasushi
Shiotani, Akihiro
author_facet Okamura, Akihiko
Watanabe, Masayuki
Mukoyama, Nobuaki
Ota, Yoshihiro
Shiraishi, Osamu
Shimbashi, Wataru
Baba, Yoshifumi
Matsui, Hidetoshi
Shinomiya, Hirotaka
Sugimura, Keijiro
Morita, Masaru
Sakai, Makoto
Sato, Hiroshi
Shibata, Tomotaka
Nasu, Motomi
Matsumoto, Shuichi
Toh, Yasushi
Shiotani, Akihiro
author_sort Okamura, Akihiko
collection PubMed
description AIM: Digestive reconstruction after pharyngolaryngectomy with total esophagectomy (PLTE) remains challenging, with the optimal method remaining unclear. The current study aimed to clarify the short‐term outcomes after PLTE and determine the optimal digestive reconstruction method. METHODS: Based on a nationwide survey of 151 patients who underwent PLTE, outcomes of digestive reconstruction methods are described. RESULTS: Among digestive reconstruction methods, a simple gastric tube was most frequently used (37.1%), followed by gastric tube combined with free graft transfer (FGT) (35.1%), gastric tube with microvascular anastomosis (22.5%), and other procedures (5.3%). Intraoperative evaluation of microcirculation (IOEM) was utilized in 29 patients (19.2%). Among the included patients, 66.9% developed any‐grade complications, 41.0% developed severe complications, and 23.8% developed digestive reconstruction‐related complications (DRRCs; leakage or necrosis). Reoperation within 30 days for any complications and DRRCs was required in 13.9% and 8.6% of the patients, respectively. Mortality within 90 days was observed in 4.6%. Among the three major methods, gastric tube combined with FGT promoted the least DRRCs in the gastric tube (P = .005), although the overall incidence of DRRCs was comparable. The use of IOEM was significantly associated with a reduction of severe DRRCs (P = .005). CONCLUSIONS: Pharyngolaryngectomy with total esophagectomy is a high‐risk surgery significantly associated with the occurrence of postoperative morbidity and mortality. Nonetheless, the addition of FGT can help prevent gastric tip complications, while IOEM can be an effective method for improving outcomes.
format Online
Article
Text
id pubmed-8786680
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-87866802022-01-31 A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan Okamura, Akihiko Watanabe, Masayuki Mukoyama, Nobuaki Ota, Yoshihiro Shiraishi, Osamu Shimbashi, Wataru Baba, Yoshifumi Matsui, Hidetoshi Shinomiya, Hirotaka Sugimura, Keijiro Morita, Masaru Sakai, Makoto Sato, Hiroshi Shibata, Tomotaka Nasu, Motomi Matsumoto, Shuichi Toh, Yasushi Shiotani, Akihiro Ann Gastroenterol Surg Original Articles AIM: Digestive reconstruction after pharyngolaryngectomy with total esophagectomy (PLTE) remains challenging, with the optimal method remaining unclear. The current study aimed to clarify the short‐term outcomes after PLTE and determine the optimal digestive reconstruction method. METHODS: Based on a nationwide survey of 151 patients who underwent PLTE, outcomes of digestive reconstruction methods are described. RESULTS: Among digestive reconstruction methods, a simple gastric tube was most frequently used (37.1%), followed by gastric tube combined with free graft transfer (FGT) (35.1%), gastric tube with microvascular anastomosis (22.5%), and other procedures (5.3%). Intraoperative evaluation of microcirculation (IOEM) was utilized in 29 patients (19.2%). Among the included patients, 66.9% developed any‐grade complications, 41.0% developed severe complications, and 23.8% developed digestive reconstruction‐related complications (DRRCs; leakage or necrosis). Reoperation within 30 days for any complications and DRRCs was required in 13.9% and 8.6% of the patients, respectively. Mortality within 90 days was observed in 4.6%. Among the three major methods, gastric tube combined with FGT promoted the least DRRCs in the gastric tube (P = .005), although the overall incidence of DRRCs was comparable. The use of IOEM was significantly associated with a reduction of severe DRRCs (P = .005). CONCLUSIONS: Pharyngolaryngectomy with total esophagectomy is a high‐risk surgery significantly associated with the occurrence of postoperative morbidity and mortality. Nonetheless, the addition of FGT can help prevent gastric tip complications, while IOEM can be an effective method for improving outcomes. John Wiley and Sons Inc. 2021-09-22 /pmc/articles/PMC8786680/ /pubmed/35106415 http://dx.doi.org/10.1002/ags3.12509 Text en © 2021 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Okamura, Akihiko
Watanabe, Masayuki
Mukoyama, Nobuaki
Ota, Yoshihiro
Shiraishi, Osamu
Shimbashi, Wataru
Baba, Yoshifumi
Matsui, Hidetoshi
Shinomiya, Hirotaka
Sugimura, Keijiro
Morita, Masaru
Sakai, Makoto
Sato, Hiroshi
Shibata, Tomotaka
Nasu, Motomi
Matsumoto, Shuichi
Toh, Yasushi
Shiotani, Akihiro
A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title_full A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title_fullStr A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title_full_unstemmed A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title_short A Nationwide Survey on Digestive Reconstruction Following Pharyngolaryngectomy With Total Esophagectomy: A Multicenter Retrospective Study in Japan
title_sort nationwide survey on digestive reconstruction following pharyngolaryngectomy with total esophagectomy: a multicenter retrospective study in japan
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8786680/
https://www.ncbi.nlm.nih.gov/pubmed/35106415
http://dx.doi.org/10.1002/ags3.12509
work_keys_str_mv AT okamuraakihiko anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT watanabemasayuki anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT mukoyamanobuaki anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT otayoshihiro anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shiraishiosamu anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shimbashiwataru anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT babayoshifumi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT matsuihidetoshi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shinomiyahirotaka anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT sugimurakeijiro anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT moritamasaru anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT sakaimakoto anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT satohiroshi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shibatatomotaka anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT nasumotomi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT matsumotoshuichi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT tohyasushi anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shiotaniakihiro anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT anationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT okamuraakihiko nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT watanabemasayuki nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT mukoyamanobuaki nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT otayoshihiro nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shiraishiosamu nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shimbashiwataru nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT babayoshifumi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT matsuihidetoshi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shinomiyahirotaka nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT sugimurakeijiro nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT moritamasaru nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT sakaimakoto nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT satohiroshi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shibatatomotaka nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT nasumotomi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT matsumotoshuichi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT tohyasushi nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT shiotaniakihiro nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan
AT nationwidesurveyondigestivereconstructionfollowingpharyngolaryngectomywithtotalesophagectomyamulticenterretrospectivestudyinjapan