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Right arrow Esophagus - cancer

Ann Thorac Surg 2005;79:1886-1889
© 2005 The Society of Thoracic Surgeons

Original article: General thoracic

Reconstruction of Recurrent Laryngeal Nerve With Involvement by Metastatic Node in Esophageal Cancer

Shoji Natsugoe, MD*, Hiroshi Okumura, MD, Masataka Matsumoto, MD, Sumiya Ishigami, MD, Tetsuhiro Owaki, MD, Shizuo Nakano, MD, Takashi Aikou, MD

Department of Surgical Oncology and Digestive Surgery, Kagoshima University School of Medicine, Kagoshima, Japan

Accepted for publication November 24, 2004.

* Address reprint requests to Dr Natsugoe, First Department of Surgical Oncology and Digestive Surgery, Kagoshima University School of Medicine, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan (E-mail: natsugoe{at}m2.kufm.kagoshima-u.ac.jp).

BACKGROUND: Recurrent laryngeal nerve paralysis represents one of the major complications in esophageal cancer surgery, and patients with esophageal cancer sometimes develop recurrent laryngeal nerve paralysis before treatment. We evaluated recurrent laryngeal nerve reconstruction in patients with lymph node metastasis infiltrating the recurrent laryngeal nerve.

METHODS: Five patients with preoperative recurrent laryngeal nerve paralysis as a result of involvement of metastasis were enrolled in the present study. Ansa cervicalis-recurrent laryngeal nerve anastomosis in the neck was performed in 4 patients and direct anastomosis of recurrent laryngeal nerve in the mediastinum in 1 patient.

RESULTS: Six months after surgery, 3 patients who had undergone ansa cervicalis-recurrent laryngeal nerve anastomosis in the neck displayed good quality of life without hoarseness or aspiration. The patient who underwent direct anastomosis of the recurrent laryngeal nerve in the mediastinum experienced occasional aspiration and hoarseness. The remaining patient displayed poor condition because of recurrent lung tumor, and quality of life was decreased.

CONCLUSIONS: If patients with recurrent laryngeal nerve paralysis before treatment can undergo potentially curative resection with lymph node dissection, including the metastatic lymph node infiltrating the recurrent laryngeal nerve, recurrent laryngeal nerve reconstruction should be performed to improve quality of life.




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