Immediate reconstruction using visceral transfer after pharyngolaryngoesophagectomy for advanced hypopharyngeal cancer.

The management of 32 stage IV cases of cancer of the hypopharynx was reviewed retrospectively with a view of selecting a pertinent treatment modality to ensure low morbidity and high survival and evaluating the applicability of abdominal viscera as a reconstructive measure after total pharyngolaryngoesophagectomy. Three methods of visceral reconstruction have been used at this hospital, viz., reversed gastric tube, colon interposition, and stomach transposition. In our experience, the gastric pull-up is more reliable. The success rate of oral alimentation of 20 gastric pull-ups was 95% and the mortality rate was 5%. The overall 3-, 5-, and 10-year survival rate was 37.5% (12/32), 38% (8/21), and 30% (3/10), respectively. Preoperative irradiation gave a 3-year survival rate of 40% (8/20) for T4 N0-3 cases.