Gastric pull-up reconstruction for pharyngo-laryngo-esophagectomy
C. E. Cahow and C. T. Sasaki
Department of Surgery, Yale University Medical School, New Haven, Conn.
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.
