Gastric Pull Up Reconstruction After Pharyngo Laryngo Esophagectomy for Advanced Hypopharyngeal Cancer

Hypopharyngeal cancers are uncommon. The management of advanced hypopharyngeal carcinomas has been a difficult problem. Surgical resection has been more successful. While many surgical methods have been used and reported pharyngolaryngo esophagectomy with gastric pull up remains the best option. This study documents our experience with patients who underwent total pharyngolaryngoesophagectomy with immediate gastric pull-up for advanced carcinoma hypopharynx. The clinical data of 17 patients treated with pharyngo-laryngo-esophagectomy for advanced carcinoma of the hypopharynx between 2001 and 2004 was analyzed. All patients had advanced disease and required a gastric pull-up for reconstruction. Data obtained included age, sex, site, stage, post op complication, duration of follow up, recurrence & survival. Average age was 37.7 years and ranged from 27 to 56 years. There were 13 female patients and 4 male patients.13 patients presented with postcricoid tumours and 4 with posterior pharyngeal wall tumors, 13 patients presented with stage 3 tumors and 4 patients presented with stage 4 tumors. Wound infection was present in 2 patients (11.7%), anastomotic leak in 1(5.8%), hypocalcemia in 1(5.8%) and malignant pleural effusion in 1 patient (5.8%). Local recurrence occurred in 1(5.8%) while nodal recurrence occurred in 5(29.4%) patient. The average over all survival in our study was 19.5 months and ranged from 2 to 101 months. The gastric pull-up operation is a useful and effective method for the immediate reconstruction of the advanced hypopharyngeal malignancy. © 2012 Indian Association of Surgical Oncology.