Free ileocolon transfer after hypopharyngo-laryngo-cervical esophagectomy for speech rehabilitation.

Patients with carcinoma of the hypopharynx or the cervical esophagus usually undergo total laryngectomy with hypopharyngo-esophagectomy and, consequently, lose the power of speech. Therefore, a reconstruction method which would enable speech rehabilitation is desirable following this type of procedure. Free ileocolon transfer consists of colo-esophagostomy, pharyngo-colostomy, ileo-tracheotomy, vascular anastomosis under a microscope, and permanent tracheostomy. In this method, the colon functions as the alimentary tract, while the ileum and ileocecal valve can produce sounds. We evaluated the results in live patients with free ileocolon transfer following hypopharyngo-laryngo-cervical esophagectomy. Although there was no case of direct operative death, one patient died from cancer progression. Four patients are still alive at from 18 to 36 months after operation. Postoperatively, stenosis of the colo-esophaogostomy appeared in two patients, but there was no case of anastomotic breakdown or any other major complication. Speech rehabilitation was good, and there was no misswallowing into the airway. We think that free ileocolon graft is one of the more preferable procedures following hypopharyngo-laryngo-cervical esophagectomy.