Open and endoscopic laryngo-pharyngeal surgery

It is well known that patients with hypopharyngeal cancer often have esophageal cancer as multiple primary cancers. We may not choose radiotherapy for patients who have already been irradiated for esophageal cancer. Therefore, we regard partial pharyngectomy for the purpose of laryngeal preservation as a very important strategy in hypopharyngeal cancer treatment. When we perform these operations, the setting of the appropriate extent of resection and the choice of reconstructive surgery are critical. Currently, we have two approaches for laryngo-pharyngeal surgery. One is endoscopic laryngo-pharyngeal surgery (ELPS) in cooperation with a gastrointestinal endoscopist as a minimum invasive surgery. We showed that this is a good therapy for patients with superficial pharyngeal cancer. Pharyngeal expansion using a curved laryngoscope is useful for observation and the spread of the lesion can be determined by gastrointestinal endoscopy. We have performed over 70 cases of ELPS in the past 7 years. The other approach is laryngeal preservation surgery for invasive hypopharyngeal cancer. In such cases, we perform pharyngeal partial excision and jejunum patch reconstruction. We have performed 40 laryngeal preservation surgeries in the past 10 years. Recently, to make an appropriate resection, we determine the extent of resection using an endoscope and perform a mucosal incision. Then, we remove the tumor by approaching from the neck. Postoperative histopathological examination showed that complete resection was achieved in all cases treated by this method. The cause-specific survival rate is approximately 90％.