Late problems after pharyngolaryngoesophagectomy and pharyngogastric anastomosis for cancer of the larynx and hypopharynx.

The late problems of 136 patients who had undergone pharyngolaryngoesophagectomy and pharyngogastric anastomosis were studied. The proportions of patients who required long-term thyroxine supplementation were 67 percent, 13 percent, and 5.3 percent of the patients who had total thyroidectomy, hemithyroidectomy, and no thyroidectomy, respectively. The proportions of patients who required calcium and vitamin D supplementation were 67 percent, 23 percent, and 17 percent, respectively. Speech rehabilitation was unsatisfactory. Alimentary functions were satisfactory in that the majority of patients were able to take in solid food. Although a sensation of obstruction of food was occasionally felt, no organic abnormality was found in any patient. Regurgitation was noted in 23 percent of the patients, and hematemesis was an occasional symptom of gastritis or gastric ulcer, although symptomatic gastric ulcer was found in only two patients. It is concluded that the long-term morbidity after this extensive procedure is mild and acceptable. The operation is recommendable for extensive tumors of the laryngopharyngeal region.