Clincopathological features and surgical treatment of laryngeal cancer

One hundred and fifty patients with laryngeal cancer were studied. The site of the primary tumor as determined by pathological examination of the postoperative specimens was supraglottic region in 86 cases [57.5%], glottic region in 59 cases [39.5%] and subglottic region in 5 cases [3%]. In 133 cases [88.6%] the cancer involved one hemilarynx, while both sides were involved in 17 cases [11.4%]. All cases were subjected to total laryngectomy, radical neck dissection was done in 36 patients [24.2%] and only 21 cases had histologically involved lymph nodes, while in 15 patients the lymph nodes were histologically negative. Pharyngeal fistula was the commonest postoperative complication, it occurred in 15.3% of cases but most of them closed spontaneously by conservative treatment

Transthoracic Vs transhiatal esophagectomy for resectable carcinoma of the esophagus

This study included 104 patients with resectable carcinoma of the esophagus subjected to esophagectomy at NCI, Cairo in the period [1981-1991]. They are divided into two groups; group A 59 patients subjected to transthoracic esophagectomy in the period [1981-1986] and group B 45 patients subjected to transhiatal esophagectomy in the period [1986-1991]. Both groups were comparable as regards age, sex and site distribution of esophageal cancer. The postoperative mortality rate was 30.5% and 11.1% in groups A and B, respectively, the leading cause of death in transthoracic esophagectomy was anastomotic leak and fatal mediastinitis [72.2%]. The postoperative morbidity was 46.2% and 17.7% in group A and B, respectively, the respiratory complications constituted [70.4%] in transthoracic esophagectomy and [31.2%] in transhiatal esophagectomy. The mean start of oral feeding was 21 days in group A and 6.3 days in group B, while the mean hospital stay was 34 days in group A and 15 days in group B and 75% of survived patients in group B were discharged from the hospital within 2 weeks. In conclusion, transhiatal esophagectomy with gastric transposition in posterior mediastinum is a safe, effective means of resecting esophageal cancer attended with least mortality and morbidity as well as shortest hospital stay