Abstract
Recently, many cases of multiple primary cancers associated with the head and neck cancer are reported.
Reconstructive methods for multiple primary cancers (mainly hypopharynx) including the thoracic esophagus have been discussed. And several problems of the esophageal reconstruction using microvascular anastomosis also have been discussed.
During five years from 1988, we have studied 83 patients who underwent esophageal recon-struction using microvascular anastomosis (Successful transfer: 81/83, 97.6%). Which comprises 12 patients who have multiple primary cancers with the thoracic esophageal cancer. In these 12 patients, 8 have had simaltaneous multiple primary cancers (The gastric pedicle with the free jejunum: 7 cases. The pedicled colon with microvascular anastomosis: 1 case). These 8 cases have achieved successful tranufer.
In order to prevent complications arised from the tracheal necrosis, the trachea was covered with a mesenteric flap (3), a pectoralis major musculo-cutaneous flap (1) or a greater omentum flap (5). There was no complication due to tracheal necrosis in these cases.
The following was very useful for recipient vessels: cervical region—the transverse cervical artery and the external jugular vein, upper region of the chest wall—the thoracoacromial artery and the cephalic vein, middle region of the chest wall—the intrathoracic artery and vein.
Also we have mentioned about the importance of the team approach at the medical treatment, and about the role of the plastic surgeon in it.
