Surgery for hypopharyngeal and cervical esophageal cancer in cases with previous thoracic esophagectomy

Abstract

We have experienced two cases, who developed hypopharyngeal and/or cervical esophageal carcinoma, after surgical treatment for thoracic esophageal cancer. Case 1 underwent previous esophageal reconstruction with a gastric tube through the posterior mediastinal route, while Case 2 did so through the retrosternal route. Both cases had gastro-esophageal anastomosis at the level of the upper mediastinum and received full-dose irradiation to the neck and the upper mediastinum. In Case 1, following total pharyngo-laryngo-esophagectomy, the gastric tube and free-jejunum were anastomosed in the mediastinum. Case 2 underwent larynx-preserving cervical esophagectomy with partial resection of the sternum and consequent free-jejunum transplantation. For both cases, gastro-jejunum anastomosis was done using a circular stapler. Postoperative courses were uneventful and Case 2 demonstrated unexpectedly good swallowing without aspiration.