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01-01-2016

Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer

Authors: Ichiro Tateya, Manabu Muto, Shuko Morita, Shin’ichi Miyamoto, Tomomasa Hayashi, Makiko Funakoshi, Ikuo Aoyama, Hirokazu Higuchi, Shigeru Hirano, Morimasa Kitamura, Seiji Ishikawa, Yo Kishimoto, Mami Morita, Juichi Ito

Published in: Surgical Endoscopy | Issue 1/2016

Abstract

Background and study aims

Narrow band imaging (NBI) combined with magnifying endoscopy enables us to detect superficial laryngo-pharyngeal cancers, which are difficult to detect by standard endoscopy. Endoscopic laryngo-pharyngeal surgery (ELPS) is a technique developed to treat such lesions and the purpose of this study is to evaluate the usefulness of ELPS for superficial laryngo-pharyngeal cancer.

Patients and methods

Seventy five consecutive patients with 104 fresh superficial laryngo-pharyngeal cancers are included in this study. Under general anesthesia, a specially-designed curved laryngoscope was inserted to create a working space in the pharyngeal lumen. A magnifying endoscope was inserted transorally to visualize the field and a head & neck surgeon dissected the lesion using the combination of the orally-inserted curved grasping forceps and electrosurgical needle knife in both hands. The safely, functional outcomes, and oncologic outcomes of ELPS were evaluated retrospectively.

Results

Median operation time per lesion was 35 min. Post-operative bleeding occurred in 3 cases and temporal subcutaneous emphysema occurred in 10 cases. No vocal fold impairment occurred after surgery. The median fasting period was 2 days and all patients except one have a normal diet with no limitations. Local recurrence occurred in 1 case, and the 3-year overall survival rate and the 3-year disease specific survival rate was 90 % and 100 %, respectively.

Conclusions

ELPS is a hybrid of head and neck surgery and gastrointestinal endoscopic treatment, and enjoys the merit of both procedures. ELPS makes it possible to perform minimally-invasive surgery, preserving both the swallowing and phonation functions.

Muto M, Katada C, Sano Y, Yoshida S (2005) Narrow band imaging: a new diagnostic approach to visualize angiogenesis in superficial neoplasia. Clin Gastroenterol Hepatol 3(7 Suppl 1):S16–S20PubMedCrossRef

Muto M, Minashi K, Yano T, Saito Y, Oda I, Nonaka S, Omori T, Sugiura H, Goda K, Kaise M, Inoue H, Ishikawa H, Ochiai A, Shimoda T, Watanabe H, Tajiri H, Saito D (2010) Early detection of superficial squamous cell carcinoma in the head and neck region and esophagus by narrow band imaging: a multicenter randomized controlled trial. J Clin Oncol 28:1566–1572PubMedPubMedCentralCrossRef

Muto M, Nakane M, Katada C, Sano Y, Ohtsu A, Esumi H, Ebihara S, Yoshida S (2004) Squamous cell carcinoma in situ at oropharyngeal and hypopharyngeal mucosal sites. Cancer 101:1375–1381PubMedCrossRef

Muto M, Satake H, Yano T, Minashi K, Hayashi R, Fujii S, Ochiai A, Ohtsu A, Morita S, Horimatsu T, Ezoe Y, Miyamoto S, Asato R, Tateya I, Yoshizawa A, Chiba T (2011) Long-term outcome of transoral organ-preserving pharyngeal endoscopic resection for superficial pharyngeal cancer. Gastrointest Endosc 74:477–484PubMedCrossRef

Shimizu Y, Yamamoto J, Kato M, Yoshida T, Hirota J, Ono Y, Nakagawa M, Nakagawa S, Oridate N, Asaka M (2006) Endoscopic submucosal dissection for treatment of early stage hypopharyngeal carcinoma. Gastrointest Endosc 64:255–259PubMedCrossRef

Iizuka T, Kikuchi D, Hoteya S, Yahagi N, Takeda H (2009) Endoscopic submucosal dissection for treatment of mesopharyngeal and hypopharyngeal carcinomas. Endoscopy 41:113–117PubMedCrossRef

Japan Society for Head and Neck Cancer (2012) General rules for clinical studies on head and neck cancer. 5th edn. Kanehara, Tokyo, Japan

Japan Esophageal Society (2008) Japanese classification of esophageal cancer. 10th edn. Kanehara, Tokyo, Japan

Sato Y, Omori Y, Tagawa M (2006) Surgical treatment for hypopharyngeal superficial cancer: endoscopic laryngo-pharyngal surgery. Nihon Jibiinkoka Gakkai Kaiho 109:581–586CrossRef

10.

Steiner W (1988) Experience in endoscopic laser surgery of malignant tumors of the upper aero-digestive tract. Adv Otorhinolaryngol 39:135–144PubMed

11.

Steiner W, Ambrsch P, Hess CF, Kron M (2001) Organ preservation by transoral laser microsurgery in piriform sinus carcinoma. Otolaryngol Head Neck Surg 124:58–67PubMedCrossRef

12.

Steiner W, Fierek O, Ambrosch P, Hommerich CP, Kron M (2003) Transoral laser microsurgery for squamous carcinoma of the base of tongue. Arch Otolaryngol Head Neck Surg 129:36–43PubMedCrossRef

13.

O’Malley BW Jr, Weinstein GS, Hockstein NG (2006) Transoral roboti surgery for tongue base neoplasms. Laryngoscope 116:1465–1472PubMedCrossRef

14.

Weinstein GS, O’Malley BW Jr, Snyder W, Hockstein NG (2007) Transoral robotic surgery: supraglottic partial laryngectomy. Ann Otol Rhinol Laryngol 116:19–23PubMedCrossRef

15.

Park YM, Byeon HK, Chung HP, Choi EC, Kim SH (2013) Comparison study of transoral robotic surgery and radical open surgery for hypopharyngeal cancer. Acta Otolaryngol 133:641–648PubMedCrossRef

16.

Tomifuji M, Araki K, Yamashita T, Shiotani A (2014) Transoral videolaryngoscopic surgery for oropharyngeal, hypopharyngeal, and supraglottic cancer. Eur Arch Otorhinolaryngol 271:589–597PubMedCrossRef

17.

Okami K, Ebisumoto K, Sakai A, Sugimoto R, Maki D, Saito K, Kaneda S, Iida M, Ogura G, Nakamura N, Nishiyama K (2013) Transoral en bloc resection of superficial laryngeal and pharyngeal cancers. Head Neck 35:1162–1167PubMedCrossRef

18.

Iizuka T, Kikuchi D, Hoteya S, Takeda H, Kaise M (2012) A new technique for pharyngeal endoscopic submucosal dissection: peroral countertraction (with video). Gastrointest Endosc 76:1034–1038PubMedCrossRef

Title: Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer
Authors: Ichiro Tateya
Manabu Muto
Shuko Morita
Shin’ichi Miyamoto
Tomomasa Hayashi
Makiko Funakoshi
Ikuo Aoyama
Hirokazu Higuchi
Shigeru Hirano
Morimasa Kitamura
Seiji Ishikawa
Yo Kishimoto
Mami Morita
Juichi Ito
Publication date: 01-01-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 1/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4213-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Endoscopic laryngo-pharyngeal surgery for superficial laryngo-pharyngeal cancer

Abstract

Background and study aims

Patients and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background and study aims

Patients and methods

Results

Conclusions

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