Abstract
Objective: 1) The type of reconstructions used; 2) complication rates; 3) duration of hospital stay; 4) perioperative mortality; and 5) disease-free interval. In this retrospective analysis, we audit the hypopharyngeal cancers that required some form of tissue augmentation for pharyngeal reconstruction after primary surgery.
Method: Retrospective analysis of predominantly hypopharyngeal cancer patients who underwent surgery at the Tata Memorial Hospital, between 2005 and 2010. Of the total 390 patients, 103 required some form of pharyngeal reconstruction. The mean age of this population was 56 years with a male to female ratio of 4:1.
Results: Fifty-three patients had reconstruction with pectoralis major myocutaneous flap. Thirty-two had gastric pull up, 12 had free jejunum, and 6 had free radial artery forearm flap. The mean hospital stay was 22 days. While the overall perioperative mortality was 10% (10/103), majority (6/10) had GPU as part of treatment. A total of 18% of patients had re-explorations, 6% had flap failures, and 23% had pharyngocutaneous fistula. Twenty percent had stricture of neopharynx and 44% had tracheostomal stenosis. The mean disease-free intervals for all patients were 12 months and 11 months with close or involved margins.
Conclusion: The choice of reconstruction should be decided preoperatively based on the overall health status of the patient. Patients undergoing GPU have higher mortality rates. Low preoperative albumin level is an indicator for perioperative mortality (P value equal to .02). Final HPR margin status may influence disease-free interval.
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