Extended esophagolaryngeal resection with parathyroid autotransplantation

Esopharyngolaryngeal resection for carcinoma of the cervical esophagus must he accompanied by resection of the thyroid gland, parathyroid bodies, and regional lymph nodes. In order to reduce long-term morbidity associated wit h the procedure, we performed parathyroid autotransplantation in two patien ts who underwent esophagolaryngeal resections. Grafting of the upper two pa rathyroid glands into the sternocleidomastoid muscle was carried out succes sfully in both cases. Graft function was rapidly restored. During the third postoperative week, blood levels of intact parathormone (PTH) reached 20 p g ml(-1) in the first case and 15 pg ml(-1) in the second, and the patients were successfully weaned off calcium and vitamin D supplementation. Parath yroid autotransplantation should be attempted in all cases of esophagolaryn geal resections provided that parathyroid glands are free of malignancy.