Mortality and morbidity of gastric 'pull-up' for replacement of the pharyngoesophagus
G. T. Ujiki, G. J. Pearl, S. Poticha, Sr. Sisson GA and T. W. Shields
Forty-two patients have undergone gastric interposition to replace the
pharyngoesophagus; 39 patients had primary or recurrent malignant tumors of
the hypopharynx, cervical esophagus, postcrioid area, or tracheal stoma,
while three patients had benign disease. The operation consisted of
resection of the local neck disease, along with a transhiatal esophagectomy
and gastric "pull-up" for restoration of gastrointestinal tract continuity.
Eight hospitalized patients died, for a mortality rate of 19%, of which six
patients died of complications from local sepsis. The more common nonfatal
complications were related to the neck wound, the anastomosis, and the
stomach. The complication rate per patient, excluding postoperative deaths,
was 40%. The average length of stay was 44 days for the patients with
nonfatal complications and 23 days for those without complications. The
success rate of the operation with relief of the patients' presenting
symptoms was 81%.
