Negative impact of tracheotomy prior to total laryngectomy for patients with advanced laryngeal cancer

Sakai, Azusa; Yokoshima, Kazuhiko; Nakamizo, Munenaga; Inai, Shunta; Sakanushi, Atsuko; Kato, Taisei; Nakaishi, Masashi; Okubo, Kimihiro

doi:10.5981/jjhnc.46.334

Cited by 2 publications

(2 citation statements)

References 6 publications

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“…This ensures the achievement of complete resection of the tumor. Sakai et al [21] also reported no difference in the recurrence pattern in patients undergoing laryngeal cancer surgery, even when tracheotomy was performed rst. If the TEF caused by the tumor is located caudal to the suprasternal margin, the tracheal cannula may not be long enough or a permanent tracheostomy may not be safely created, in which case stenting to close the stula or esophageal bypass may be considered.…”

Section: Discussionmentioning

confidence: 96%

A case of advanced hypopharyngeal cervical esophageal cancer with management of tracheoesophageal fistula and complete resection

Ohno¹,

Tanaka²,

Endo³

et al. 2022

Preprint

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Background: Advanced esophageal cancer with tracheal invasion is fatal due to airway narrowing, and due to the possibility of tracheoesophageal fistula formation during the treatment process. If a tracheoesophageal fistula develops, palliative care is often chosen, and curative resection is very rarely achieved.Case Presentation: A 71-year-old man presented with dysphagia. He was diagnosed hypopharyngeal and cervical esophageal cancer with severe airway stenosis (cT4b [main bronchus, thyroid] N3 M0 cStageIIIC); we initially created a tracheostomy. He received induction chemotherapy (docetaxel, nedaplatin and S-1: DGS). After one course of DGS therapy, he developed a tracheoesophageal fistula due to tumor shrinkage. We managed both the airway route and nutrition strictly under continuous suctioning over the cuff of the tracheal cannula, prohibited swallowing saliva, and provided enteral nutrition using a nasogastric tube. Three courses of DGS therapy were performed. A clinical complete response was achieved. We then performed pharyngo-laryngo-esophagectomy. The postoperative course was uneventful. His response was evaluated as a pathological complete response (pretreatment effect grade 3) and we achieved R0 resection. Two courses of DGS therapy were administered as adjuvant chemotherapy. He is currently alive without recurrence at 9 years after treatment.Conclusions: In the case of upper tracheoesophageal fistula caused by advanced hypopharyngeal cervical esophageal cancer, chemotherapy under strict airway and nutritional management after tracheostomy may facilitate radical surgery.

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Section: Discussionmentioning

confidence: 96%

A case of advanced hypopharyngeal cervical esophageal cancer with management of tracheoesophageal fistula and complete resection

Ohno¹,

Tanaka²,

Endo³

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…By performing biopsy of the cutting level of the trachea preoperatively by bronchoscopy through the tracheostomy site and determining the cutting level of the trachea to confirm a negative biopsy, we thereby ensured performance of complete resection of the tumor. Sakai et al [ 26 ] also reported no difference in recurrence pattern in laryngeal cancer surgery even if a tracheotomy was performed first. If the TEF caused by the tumor is located caudal to the suprasternal margin, the tracheal cannula may not be long enough or a permanent tracheostomy may not be safely created, in which case stenting to close the fistula or esophageal bypass should be considered.…”

Section: Discussionmentioning

confidence: 99%

A case of advanced hypopharyngeal cervical esophageal cancer treated by curative resection with management of tracheoesophageal fistula

Ohno

Tanaka

Sato

et al. 2023

Clin J Gastroenterol

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Advanced esophageal cancer with tracheal invasion is fatal due to airway narrowing and the possibility of tracheoesophageal fistula (TEF) formation during the treatment process. If a TEF develops, palliative care is often chosen. It is very rare that curative treatment is performed including with chemoradiotherapy (CRT) or surgery in such cases. A 71-year-old man presented with dysphagia. He was diagnosed as having hypopharyngeal and cervical esophageal cancer with severe airway stenosis (cT4b [main bronchus, thyroid] N3 M0 cStage IIIC), and we initially created a tracheostomy. Second, we chose induction chemotherapy to avoid fistula formation by CRT, but after one course of chemotherapy, he developed a TEF due to remarkable tumor shrinkage. We strictly managed both his airway and nutrition by continuous suctioning over the cuff of the tracheal cannula and prohibiting swallowing of saliva and enteral nutrition via nasogastric tube. After three courses of chemotherapy were administered, we performed pharyngo-laryngo-esophagectomy followed by adjuvant chemotherapy. The patient remains alive and recurrence free at 9 years postoperatively. In cases of upper TEF caused by advanced hypopharyngeal and cervical esophageal cancer, radical treatment may be possible by effective induction chemotherapy combined with strict airway and nutritional management after prior tracheostomy.

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Negative impact of tracheotomy prior to total laryngectomy for patients with advanced laryngeal cancer

Cited by 2 publications

References 6 publications

A case of advanced hypopharyngeal cervical esophageal cancer with management of tracheoesophageal fistula and complete resection

A case of advanced hypopharyngeal cervical esophageal cancer with management of tracheoesophageal fistula and complete resection

A case of advanced hypopharyngeal cervical esophageal cancer treated by curative resection with management of tracheoesophageal fistula

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