Reconstruction using pedicled jejunal segments after resection for carcinoma of the cervical esophagus.

During the past 21 years, 45 (76.3 per cent) of 59 instances of cervical and hypopharyngeal carcinomas were treated by resection. The standard operative procedure for reconstruction after resection was interposition of pedicled jejunal segments between the cervical esophagus or the hypopharynx and the upper part of the thoracic esophagus with or without total laryngectomy, a procedure developed by one of the authors. The five year survival rate of 11 patients who underwent this operation which preserves the larynx was 33.3 per cent and that of 19 patients who underwent the operation with laryngectomy was 19.7 per cent. Therefore, the interposition of jejunal segments preserving the larynx is shown to be an appropriate operation for carcinoma localized in the cervical esophagus. In addition, reconstruction with free jejunal segments using microvascular operations in instances of recurrent malignant tumors of the thoracic esophagus in the cervical esophagus is introduced.