We evaluated swallowing function in four tongue cancer patients who underwent hemiglossectomy and reconstruction with the pectoralis major myocutaneous flap at 12 months postoperatively . The size of the pectoralis major myocutaneous flap was almost 12 × 5 cm in those four patients. In all patients, the flaps decreased in comparison with the size one month postoperatively. We performed functional evaluation. All patients were capable of oral ingestion. Patients who underwent excision of less than 50% of the radix linguae could consume an approximately normal diet. However, patients who underwent excision of more than 50% of the radix linguae required strict dietary limitations. We evaluated video fluorography findings. None of the patients could hold the test diet in the oral cavity. All patients could shift the residual tongue to the flap side as a compensatory function and the residual tongue could make good contact with the hard palate. There was no aspiration in any patient. Widening of the esophageal entrance during swallowing appeared good in all patients. We suggest that swallowing function in patients who underwent hemiglossectomy and reconstruction with a pectoralis major myocutaneous flap was good approximately at 12 months postoperatively.
Abscess formation is one of the most common complications of colorectal cancer. The presence of abscesses and accompanying fibrosis sometimes makes it difficult to correctly diagnose the extent of tumor invasion, thereby affecting the choice of surgical procedure. We report the case of a 57–year–old male with locally advanced rectosigmoid cancer complicated by widespread scrotal and perineal abscesses. The patient was treated by total pelvic exenteration, total emasculation, and combined partial resection of the ileum to achieve en bloc excision of the tumor and all of the scrotal and perineal abscess cavities. Histological examination of the surgical specimen revealed cancer cells floating in the abscess cavity of the ileal mesentery but not in the scrotal and perineal abscess cavities. Colorectal cancer patients with widespread abscess formation sometimes require extended surgery to achieve microscopically complete resection, because it is impossible to reliably discriminate between cancerous tissue and the surrounding inflammation accompanyed by fibrosis pre– or intra–operatively. Although extended surgery is necessarily followed by impaired quality of life, it is the most promising treatment available in terms of a cure.