Gastric pull-up for cancers of the hypopharynx and cervical esophagus: our experience.

Twenty-five cases of squamous cancer of the hypopharynx and cervical esophagus treated with laryngopharyngoesophagectomy and pharyngogastric anastomosis are presented. In all cases the lesion was such that a complete circumferential pharyngectomy was necessitated. Twelve patients had received full radiation therapy and surgery was undertaken for residual and recurrent disease. Eleven patients had a concurrent unilateral radical neck dissection and two patients a concurrent bilateral neck dissection. Five patients died within 1 month following surgery. The causes of death are discussed. The most notable features of this method of pharyngeal and cervical esophageal reconstruction is the early restoration of swallowing (20 patients were on oral feed in less than 10 days following surgery), a very low incidence of anastomatic leak and subsequent hazards of a carotid hemorrhage (only one patient had a major leak leading to carotid hemorrhage), and absence of subsequent anastomotic stenosis as is seen after reconstruction with skin tubes.