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Japanese Journal of Clinical Oncology Advance Access published online on February 12, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hym177
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© The Author (2008). Published by Oxford University Press. All rights reserved

Planned Simultaneous Cervical Skin Reconstruction for Salvage Total Pharyngolaryngectomy

Kenta Watanabe1,, Takahiro Asakage1, Kazunari Nakao1, Yasuhiro Ebihara1, Yoshinori Fujishiro1, Mutsumi Okazaki2, Hirotaka Asato2 and Masashi Sugasawa1

1 Department of Otolaryngology, University of Tokyo, Tokyo
2 Department of Plastic and Reconstructive Surgery, University of Tokyo, Tokyo, Japan

For preprints and all correspondence: Kenta Watanabe, Department of Otolaryngology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. E-mail: Quentaw{at}aol.com

Received October 1, 2007; accepted December 17, 2007

Background: Salvage surgery after definitive radiotherapy with or without chemotherapy is still controversial, especially in cases of hypopharyngeal cancer because of the poor prognosis and surgical complications. Irradiation of the skin results in loss of flexibility of the skin and impairment of the normal healing processes, thereby increasing the risk of wound infections, which could be potentially life-threatening. In an attempt to diminish the risk of major complications, we performed planned cervical skin replacement with salvage total pharyngolaryngectomy (TPL).

Methods: From 2005 to 2006, six patients underwent salvage TPL and cervical reconstruction with a deltopectoral flap at our hospital. The cervical skin replacement was determined pre-operatively and not according to the intraoperative status.

Results: There were no major post-operative complications. Both the prolongation of the operation time and of the duration of hospitalization were within acceptable limits.

Conclusion: Planned cervical skin reconstruction appears to be an appropriate and acceptable procedure with salvage pharyngolaryngectomy to avoid major complications.

Key Words: hypopharyngeal cancer • reconstruction • chemoradiotherapy • salvage surgery • complication


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