April 1994

Gastric Pull-up Reconstruction for Pharyngo-laryngo-esophagectomy

Author Affiliations

From the Department of Surgery (Drs Cahow and Sasaki), the Sections of General Surgery (Dr Cahow) and Otolaryngology (Dr Sasaki), Yale University Medical School, New Haven, Conn.

Arch Surg. 1994;129(4):425-430. doi:10.1001/archsurg.1994.01420280103013

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.(Arch Surg. 1994;129:425-430)