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Algorithmic Approach Using Negative Pressure Wound Therapy Improved Survival for Patients with Synchronous Hypopharyngeal and Esophageal Cancer Undergoing Pharyngolaryngoesophagectomy with Gastric Tube Reconstruction

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

This study retrospectively analyzed the feasibility and surgical outcome of an algorithmic approach using negative pressure wound therapy for patients with synchronous hypopharyngeal and esophageal cancer undergoing pharyngolaryngoesophagectomy with gastric tube reconstruction.

Methods

Patients undergoing pharyngolaryngoesophagectomy and gastric tube reconstruction for hypopharyngeal cancer between 2011 and 2019 were candidates for this study. Data were collected on patient demographics, comorbidities, performance status, cancer stage, treatment, complication, and survival. Survival analysis was performed using the Kaplan-Meier method. The Cox proportional hazards model was used for prognostic factors.

Results

The study enrolled 43 patients. Anastomotic leakage was found in 21 of the patients with a conventional surgical drain (61.9%) and in 10 of the 22 patients with negative pressure wound therapy (45.5%) (p = 0.280). Nine patients in the conventional drain group (42.9%) and two patients in the negative pressure wound therapy group (9.1%) had leakage-associated complications (p = 0.011). The incidence of pulmonary complications was higher in the conventional surgical drain group (9 vs 2; p = 0.011). The number of complications requiring surgery was higher in the conventional drain group (7 vs 0; p = 0.004). The overall survival in the negative pressure wound therapy group was better (hazard ratio [HR], 0.33; 95% confidence interval [CI], 0.15–0.76; p = 0.009). Negative pressure wound therapy was independently associated with overall survival (HR, 0.31; 95% CI, 0.13–0.77; p = 0.011).

Conclusions

Negative pressure wound therapy with an algorithmic approach improved the overall survival for the patients undergoing gastric tube reconstruction after pharyngolaryngoesophagectomy for hypopharyngeal and esophageal cancer by preventing deadly complications secondary to anastomotic leakage

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan

    Chao-Chun Chang MD, Wen-Ruei Tang MD, Wei-Li Huang MD, Ying-Yuan Chen MD, Yi-Ting Yen MD, PhD & Yau-Lin Tseng MD, PhD

  2. Division of Trauma and Acute Care Surgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan

    Chao-Chun Chang MD & Yi-Ting Yen MD, PhD

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  1. Chao-Chun Chang MD
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  2. Wen-Ruei Tang MD
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  4. Ying-Yuan Chen MD
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Correspondence to Yi-Ting Yen MD, PhD.

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Chang, CC., Tang, WR., Huang, WL. et al. Algorithmic Approach Using Negative Pressure Wound Therapy Improved Survival for Patients with Synchronous Hypopharyngeal and Esophageal Cancer Undergoing Pharyngolaryngoesophagectomy with Gastric Tube Reconstruction. Ann Surg Oncol 28, 8996–9007 (2021). https://doi.org/10.1245/s10434-021-10365-8

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  • DOI: https://doi.org/10.1245/s10434-021-10365-8

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