[Laryngeal cancer: postop complications and possibilities of their correction]. / Niepowodzenia leczenia operacyjnego raka krtani i mozliwosci ich korygowania.

ABSTRACT

The aim of the paper is to present the surgical methods applied in a 76 year old patient treated for carcinoma of the larynx. As an effect of the carried out total laryngectomy, extensive pharyngeal fistula occurred. The fistula was closed with myocutaneous flap which was pedunculated on double reversed pectoral major muscle. Due to lymphatic metastases surgical dissection of lymphatic system of the left side of the neck was performed 2 years after laryngectomy. During this operation the left common cervical artery was removed (Goretex graft). Next-cobaltotherapy was applied. After following 2 years the skin necrosis just over the flap occurred. It was caused by shirt collar pressure. Because of the major bleeding common cervical artery was oligated. During this procedure the frontal wall of the oesophagus was damaged and again pharyngeal fistula appeared. Attempts at closing it with flaps pedunculated on pectoral major muscle and trapezius muscle did not succeed. Finally fistula was closed with cylindric flap from the abdomen connected with the cutaneous flap from surrounding fistula tissues. Following recognition of this illness the patient had undergo nine consecutive, extensive operations. Ten years after diagnosis he is still alive and leads a life appropriate to his age.