Faringocoloplastia como reconstrução tardia pós-faringolaringectomia total por carcinoma espinocelular de hipofaringe: relato de caso e revisão da literatura

Head and neck squamous cell carcinoma represents about 5% of all malignant tumors. Localization of this neoplasia at the upper aerodigestive tract is an important prognostic factor. In most cases, hypopharynx tumors are at an advanced stage when diagnosed. Surgical resection, as well as alongside chemotherapy and radiotherapy, are essential to the treatment. Many patients with locoregional control of the disease benefit from reparative and reconstructive surgeries of the intestinal transit. Case report: Man, 38 years old, former user of alcohol and tobaco, complaining of rapid progressive dysphagia and dyspnea, submitted to urgent tracheotomy due to acute respiratory failure. At examination, we diagnosed supraglottic squamous cell carcinoma, involving the left pyriform fossa medial wall. The patient underwent a pharyngolaryngectomy, followed by chemoradiation. Without signs of tumor recurrence after a 12-month follow-up, we performed a pharyngocoloplasty with reconstruction of the intestinal transit. At the moment, he is attending for an outpatient follow-up, with no evidences of tumor recurrence, and satisfied with the final surgical outcome. Discussion: The reconstruction of intestinal transit in pharyngolaryngectomy patients is indicated for those with local control of the disease and that accept this surgical procedure. The most used technique is the loop interposition of small intestine, but the colon is also used for esophageal replacement. Its choice depends mainly on the technical accuracy of the surgeon, but also on the requirement of a lengthy loop for the anastomosis between pharynx and the stomach, with suitable results.