Reconstruction of Hypopharyngeal and Esophageal Defects Using a Gastric Tube after Total Esophagectomy and Pharyngolaryngectomy.

AIM: This study investigated the value of gastric tube during surgery for advanced hypopharyngeal and cervical esophageal cancer. METHOD: From November 2007 to December 2012, 42 patients underwent total pharyngo-laryngo-esophagectomy because of advanced hypopharyngeal or cervical esophageal cancer and were reconstructed with a gastric tube. Clinical swallowing function, morbidity, overall survival, and progression-free survival were evaluated postoperatively. RESULT: There were no severe complications, including no gastric necrosis, surgery-related postoperative morbidity, hemothorax, thoracostomach, or severe reflux esophagitis. Anastomotic leakage occurred in 2 cases, and these patients healed spontaneously with conservative management. Pulmonary infection developed in 5 patients. Anastomotic stenosis occurred in 2 cases and was managed with endoscopic dilatation. Regurgitation during the night was observed in 5 cases and was controlled by medication. All the patients regained their swallowing ability and thereby increased their quality of life. All patients were followed for 30-60 months; 2 of them were lost 6 months after surgery. The 3-year overall and progression-free survival rates were 58.1 and 56.2% respectively, and the 5-year overall and progression-free survival rates were 27.6 and 21.8%, respectively. CONCLUSION: Reconstruction by gastric tube is a dependable one-stage procedure that restores gastrointestinal continuity after total pharyngo-laryngo-esophagectomy.