Background Factors Associated with Postoperative Complications in Patients with Advanced Hypopharyngeal Cancers Undergoing Total Pharyngolaryngoesophagectomy Followed by Free Jejunal Flap Reconstruction

We retrospectively analyzed the background factors associated with postoperative complications in patients with advanced hypopharyngeal cancers who underwent total pharyngolaryngectomy followed by free jejunal flap reconstruction. A total of 23 subjects, including 21 men and 2 women in age range of 49 to 83 years (average, 72.3 years) were enrolled in this study. Mild and moderate/severe complications occurred in 5 and 7 cases, respectively. The most common complication was stricture of the esophagojejunal anastomosis (9 cases). Other complications, including tracheostomal stenosis, pneumonia and chyle leakage occurred in 2, 1, 1 cases, respectively. The free jejunal flap survived in all cases. The disease-free survival rate was 47.8% at 52 weeks after surgery. The platelet count was significantly lower (18.8 ± 1.9 × 104/μL vs. 27.7 ± 1.8 × 104/μL; P = 0.008) in patients with moderate/severe complications than in those without. The percentage of stage IV cases and intraoperative blood loss tended to be greater in patients with complications than in those without. We should be aware of these potential risk factors for the development of postoperative complications in order to satisfactorily manage the clinical course of patients with advanced hypopharyngeal cancers.