Brücher B L D M, Sarbia M, Oestreicher E, Molls M, Burian M, Biemer E, Stein H J
Department of Surgery, Technical University of Munich, Munich, Germany.
Dis Esophagus. 2007;20(1):75-8. doi: 10.1111/j.1442-2050.2007.00648.x.
Squamous cell carcinoma in a Zenker diverticulum is a very rare condition. We report a case of a patient with a Zenker carcinoma, who was primarily functionally inoperable and therefore received neoadjuvant radiochemotherapy before cardiac bypass surgery. After a complicated course with cardiogenic shock and myocardial infarction, a re-evaluation of functional risk analysis and the tumor situation revealed operability. Subsequently, partial hypopharyngectomy and partial cervical esophageal resection with lymphadenectomy was performed. Reconstruction of the gastrointestinal continuity was made by interposition of a free small bowel graft and microvascular anastomosis. The postoperative course showed a small anastomotic leakage of the hypopharyngeal-small bowel anastomosis, which was successfully treated conservatively.
Zenker憩室中的鳞状细胞癌是一种非常罕见的病症。我们报告一例Zenker癌患者，该患者最初在功能上无法手术，因此在心脏搭桥手术前接受了新辅助放化疗。在经历了心源性休克和心肌梗死的复杂病程后，对功能风险分析和肿瘤情况进行重新评估显示具备手术可行性。随后，进行了部分下咽切除术、部分颈段食管切除术及淋巴结清扫术。通过置入游离小肠移植物和微血管吻合重建胃肠道连续性。术后病程显示下咽-小肠吻合口有少量吻合口漏，经保守治疗成功治愈。
