Krasna M J, Phillips S D, Gray W C, Biedlingmaier J F
Division of Otolaryngology, University of Maryland Medical School, Baltimore 21201, USA.
Ann Thorac Surg. 1995 Dec;60(6):1821-3. doi: 10.1016/0003-4975(95)00738-5.
Pharyngogastric anastomosis, otherwise referred to as the "gastric pull-up" procedure, is the most reliable method of reconstruction after laryngopharyngectomy. We currently use a method of gastric to pharyngeal anastomosis that avoids excess tension, and thus decreases the incidence of fistulas and flap failures. With the stomach fully mobilized, the "pull-up" is brought high into the neck using a plastic bag to facilitate delivery via the posterior mediastinum. A curved, U-shaped incision is then made in the fundus of the tongue anteriorly, allowing the posterior nasopharynx to be reached without tension.
