GASTRIC PULL-UP RECONSTRUCTION FOR PHARYNGOLARYNGOESOPHAGECTOMY IN HEAD AND NECK CANCER AND CERVICAL ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract

There are many techniques for reconstruction after total pharyngolaryngoesophagectomy. The use of a transposed stomach to restore gastrointestinal continuity, and this combined cervical and abdominal approach for pharyngolaryngoesophagectomy and gastric pull up has become one of the most popular. This retrospective study is a review of 50 consecutive Iranian patients who underwent pharyngolaryngoesophagectomy and gastric pull up in Amir-Alam Hospital affiliated to Tehran University of Medical Sciences, to determine the complication and survival rates. The clinical data of 50 consecutive cases of cervical esophagus carcinoma and squamous cell carcinoma of the hypopharynx treated by pharyngolaryngoesophagectomy and gastric pull-up were analysed. The age, gender, operating room time, operative mortality, major postoperative complications and survival rate were retrieved. Survival time was studied using Kaplan-Meier method. The postoperative complications were wound infection in five patients, pulmonary complications in ten, Stomal stenosis in six, cutaneous fistula in four, Gastric outlet obstruction in three. There were no intraoperative deaths. One month mortality was 10 per cent. The median survival for patients who underwent pharyngolaryngoesophagectomy and gastric pull-up procedures was 21 months and the 5-year survival was 18%.