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At the 32nd annual meeting of the American Society for Head and Neck Surgery, Palm Beach, Fla, April 30, 1990, Sir Donald Harrison presented a treatment rationale for patients at high risk for stomal recurrence. Harrison reiterated that the prevention of stomal recurrence is much more feasible than treatment of this devastating problem. He further stated that the patients with cricoesophageal and subglottic cancers are at high risk for stomal recurrence based on clinicopathologic evidence of residual disease in the trachea, tracheoesophageal wall, or metastasis in the paratracheal lymph nodes of surgical specimens. The manubrium and clavicular heads at times hamper the surgeons' ability to obtain an inferior margin, and to adequately clear the paratracheal and upper mediastinal nodes.
Harrison reported on his series of 71 manubrial resections for the prevention of stomal recurrence. His patients were divided into three groups based on disease location or the need for a gastric
WEBER RS. The Value of Manubrial Resection in Avoiding Stomal Recurrence. Arch Otolaryngol Head Neck Surg. 1990;116(10):1121. doi:10.1001/archotol.1990.01870100015001