Gastric pull-up reconstruction for pharyngo-laryngo-esophagectomy.

OBJECTIVE

To determine the results of gastric pull-up reconstruction following pharyngo-laryngo-esophagectomy.

DESIGN

Retrospective review of 59 patients who underwent gastric pull-up reconstruction for carcinoma of the hypopharynx, larynx, and cervical esophagus during a 10-year period from 1983 to 1993.

SETTING

Combined Head and Neck Service and Section of General Surgery, Department of Surgery, Yale University Medical School, New Haven, Conn.

MAIN OUTCOME MEASURES: Morbidity, mortality, time to oral feeding, length of hospitalization, and long-term results.

RESULTS

The mortality rate was 5%, perioperative morbidity rate, 27%, and the medical morbidity rate, 32%. Most patients took oral feedings within 6 days after surgery and were discharged within 16 days. There were two temporary fistulas and four strictures, none of which were permanent. There were no intrathoracic or mediastinal injuries or hemorrhage. The overall survival was 1 to 100 months (median survival, 12 months); the median survival was 34 months for patients alive to date and 8 months for patients who died.

CONCLUSIONS

The gastric pull-up reconstruction is a safe, effective operation with a low mortality rate and excellent long-term functional results for patients with extensive carcinoma of the hypopharynx, larynx, and cervical esophagus.