Objective: To explore a new method for the reconstruction of defect after resection of hypopharyngeal and cervical esophageal cancer using pulled-up stomach combined with free jejunal flap or lanryngotracheal flap if pulled-up stomach can not reach the level of oral pharynx for ananstamosis.
Methods: From June 2010 to June 2014, 56 cases of hypopharyngeal or cervical esophageal cancer were treated with pharyngogastric anastamosis, in 5 cases of them, because the length of pulled-up stomach was limited and could not reach oral pharynx, free jejunal flap was used in 2 cases with laryngeal invasion and laryngotracheal flap was used in 3 cases without laryngeal invasion to reconstruct the defect between oral pharynx and stomach.
Results: Pharyngeal fistula occurred in 1 case with laryngotracheal flap reconstruction, but healed after 2 weeks of wound dressing. Other 4 cases had oral liquid diet two weeks after surgery and did not occur any complications such as infection or pharyngeal fistula. Follow-up showed 1 case died from mediastinal and lung metastases after 3 years, 1 case had cervical lymph recurrence after 2 years and still survived, and other 3 cases were tumor free survival for 28, 37, and 56 months respectively.
Conclusions: The defect after resection of hypopharyngeal and esophageal cancer can be reconstructed with pulled-up stomach combined with free jejunal flap or lanryngotracheal flap if pulled-up stomach can not reach the level of oral pharynx for ananstamosis.