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World J Gastroenterol. Jul 28, 2006; 12(28): 4561-4564
Published online Jul 28, 2006. doi: 10.3748/wjg.v12.i28.4561
Intraoperative endoscopy in obstructive hypopharyngeal carcinoma
Predrag Pesko, Milos Bjelovic, Predrag Sabljak, Dejan Stojakov, Ebrahimi Keramatollah, Dejan Velickovic, Bratislav Spica, Branka Nenadic, Aleksandra Djuric-Stefanovic, Djordjije Saranovic, Vera Todorovic
Predrag Pesko, Milos Bjelovic, Predrag Sabljak, Dejan Stojakov, Ebrahimi Keramatollah, Dejan Velickovic, Bratislav Spica, Department of Esophagogastric Surgery, First Surgical University Hospital, Clinical Center of Serbia, Belgrade, Serbia and Montenegro
Branka Nenadic, Institute of Anesthesiology, First Surgical University Hospital, Clinical Center of Serbia, Belgrade, Serbia and Montenegro
Aleksandra Djuric-Stefanovic, Djordjije Saranovic, Department of Radiology, First Surgical University Hospital, Clinical Center of Serbia, Belgrade, Serbia and Montenegro
Vera Todorovic, Institute of Medical Investigations, Belgrade, Serbia and Montenegro
Correspondence to: Dr Milos Bjelovic, Department of Esophagogastric Surgery, First Surgical University Hospital, Clinical Center of Serbia, Koste Todorovica St. 6, 11000 Belgrade,Serbia and Montenegro. m.bjelovic@med.bg.ac.yu
Telephone: +381-11-3582632
Received: July 10, 2005
Revised: July 22, 2005
Accepted: August 3, 2005
Published online: July 28, 2006
Abstract

AIM: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.

METHODS: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7 (22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach.

RESULTS: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present.

CONCLUSION: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

Keywords: Hypopharynx, Neoplasms, Squamous cell, Endoscopy, Multiple primary, Synchronous tumors