Gastric transposition for head and neck cancer: a critical update
Article Abstract:
A reliable method of reconstructing the area between the pharynx (throat) or esophagus (muscular tube connecting the throat to the stomach) is stomach transposition, a procedure that pulls up the stomach to connect it with the remaining stump of esophagus or pharynx. There are other alternatives such as jejunal (intestinal) autograft, if the area requiring restoration located in the esophagopharyngeal area above the clavicle (collarbone). To permit future comparisons of various methods, an update is presented of experience with the stomach transposition procedure. A review was undertaken of 120 patients who underwent reconstruction using the transposed stomach from 1973 through September 1990. Patients underwent either excision of the esophagus at the level of the neck or circumferential excision of the pharynx. Before 1978, surgery was performed mainly for esophageal cancer; since 1979, most of the procedures were associated with hypopharyngeal tumors (tumors in the lowermost portion of the throat, leading to the larynx). There were 62 patients with pharyngeal tumors, 43 with esophageal tumors, seven with tumor recurrence, and eight patients with cancers of other primary sites, including four thyroid cancers. The mortality from complications of surgery 11 percent; it was significantly higher in patients over 60 . Patients who underwent esophageal resection had a 14 percent mortality compared with 5 percent mortality for those with pharyngeal cancer. Sixty-six patients (55 percent) experienced a total of 105 complications; most were directly related to the technical problems of the procedure. There were 24 complications involving other areas of the body, such as the lungs (pneumonitis respiratory failure), the heart, and the liver. Transposition of the stomach can successfully restore gastrointestinal continuity, but the procedure has a high risk of complications and mortality. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1991
User Contributions:
Comment about this article or add new information about this topic:
Cutaneous melanoma of the head and neck
Article Abstract:
The medical records of 289 patients who were diagnosed with cutaneous melanoma (a type of skin cancer) between 1964 and 1984 were examined to correlate surgical treatment with age, sex, site of initial cancer, site and treatment of recurrence, presence of ulceration, tumor thickness and survival. Facial skin lesions affected 43 percent of the patients, and scalp and neck lesions affected 28 and 20 percent, respectively. The remaining 8 to 9 percent had external ear lesions. Almost 50 percent of the patients were in advanced stages of the disease, characterized by increased tumor thickness, at the time of diagnosis. The overall five- and 10-year survival rates were 56 and 45 percent, respectively. However, the survival rate for patients with scalp lesions was only 42 percent, compared with 70 and 57 percent for neck and face lesions, respectively. Factors that appeared to have a negative impact on the outcome included age greater than 55 years, male gender, ulceration of the lesion, and location of the lesion on the scalp. Metastasis does not appear to be of as great a concern in cutaneous melanoma as in squamous cell carcinoma; elective removal of lymph nodes in these patients apparently had little influence on survival. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Nonsteroidal anti-inflammatory drugs and peptic ulcer disease
- Abstracts: CA 125 regression: a model for epithelial ovarian cancer response. Development and characterization of an interleukin-2-transduced human ovarian carcinoma tumor vaccine not expressing major histocompatibility complex molecules
- Abstracts: Use of folic acid for the prevention of spina bifida and other neural tube defects - 1983-1991. Recommendations for use of folic acid to reduce number of spina bifida cases and other neural tube defects
- Abstracts: Localization of endocrine tumors of the pancreas with endoscopic ultrasonography. Preoperative staging of esophageal cancer: comparison of endoscopic US and dynamic CT
- Abstracts: Medicaid eligibility patterns of persons with AIDS in California and New York, 1982-1987. The epidemiology of AIDS in the New York and California medicaid programs