Endoscopic laryngo-pharyngeal surgery (ELPS) for post-radiation superficial carcinoma in hypopharynx

Endoscopic laryngo-pharyngeal surgery (ELPS) is a trans-oral surgery in which superficial lesions are resected directly with the assistance of a laryngoscope. Four cases of post-radiation superficial carcinoma in the hypopharynx were resected with ELPS. Two cases were cancer remaining or recurrence of post-radiation T2 hypopharynx carcinomas, and two other cases were secondary superficial carcinomas. In one case, the surgical margin was positive and ELPS was performed again. In all cases, the carcinomas were completely resected. A curved laryngoscope enabled us to expand the hypopharynx. A magnifying NBI endoscope, lugor staining, and EUS were useful for identifying the area of the lesion. ELPS enabled us to do en bloc resection even for large lesions that could not be treated with EMR or with microscopic surgery. Superficial carcinoma of the hypopharynx seems to be treatable in the first place with ELPS even in post-radiation cases of cancer remaining or recurrence. In these cases, additional treatment must be considered with pathological diagnosis of the ELPS.