Rezumat
Cancerul laringian recidivat are incidenţã de 25-50% şi ratã de supravieţuire
la 5 ani de 23-35%. Chirurgia este cel mai bun tratament pentru a realiza
controlul local a recidivei tumorale. În acest articol, se prezintã strategia
chirurgicalã în cazul unui pacient cu antecedente de laringectomie radical
modificatã pentru cancer laringian şi cu recidivã tumoralã la nivelul
traheostomiei extinsã la traheea toracicã şi la esofag. Timpul chirurgical de
rezecţie a inclus manubriul sternal, traheea toracicã superioarã, esofagul în
totalitate şi limfoganglionii mediastinali superiori. Timpul chirurgical de
reconstrucţie a inclus traheostomia mediastinalã anterioarã şi esofagoplastia
cu grefon colic pediculat simultan cu lamboul de pectoral mare pentru
acoperirea defectului sternal.
Cuvinte cheie: cancer laringian recidivat, traheostomia mediastinalã ante-
rioarã, esofagoplastia, grefon colic
Abstract
Recurrent laryngeal cancer has an incidence of 25-50% and a 23-35% five-
year survival rate. Surgery is the best treatment in order to control local
recurrence. Herein, we present our surgical strategy for a patient with a his-
tory of modified radical laryngectomy for laryngeal cancer and with recurrent
tumor at the cervical tracheostomy site extended to the thoracic trachea and
esophagus. The wide resection included the sternal manubrium, the upper
thoracic trachea, the entire esophagus and the upper mediastinal lymph
nodes. The reconstruction included anterior mediastinal tracheostomy and
esophagoplasty with pedicled colonic graft simultaneously with pectoralis
major flap for covering the sternal defect.
Key words: recurrent laryngeal cancer, anterior mediastinal tracheostomy,
esophagoplasty, colonic graft
Simultaneous Total Esophagectomy and Anterior
Mediastinal Tracheostomy for Recurrent Laryngeal
Cancer Extended to the Superior Mediastinum
Marius Fodor
1
, Marcel Cosgarea
2
, Lucian Fodor
3
1
Department of General and Vascular Surgery, County Hospital, Cluj-Napoca, Romania
2
Department of ENT, County Hospital, Cluj-Napoca, Romania
3
Department of Plastic Surgery, County Hospital, Cluj-Napoca, Romania
Corresponding author:
Marius Fodor, MD, PhD
Department of General and Vascular
Surgery, County Hospital
Str. Clinicilor 1-3, 400006 Cluj-Napoca
Romania
E-mail: drfodor@yahoo.com
Received: 16.10.2016
Accepted: 13.01.2017
Chirurgia, 112 (1), 2017 63
Chirurgia (2017) 112: 63-67
No. 1, January - February
Copyright© Celsius
http://dx.doi.org/10.21614/chirurgia.112.1.63
Case Report