A new surgical technique for voice restoration after laryngopharyngoesophagectomy with a free ileocolic graft: preliminary report.
We describe a new one-stage surgical technique for voice restoration combined with reconstruction of the cervical esophagus after laryngopharyngoesophagectomy with a free ileocolic autograft. Reconstruction of the alimentary tract is accomplished with the colonic segment, and the phonatory shunt is fashioned from the terminal ileum. The ileocolic valve, reinforced by "cecal application," functions as an inherent valve that prevents aspiration through the shunt. Six patients underwent reconstruction with this method. There was no graft necrosis, although one venous anastomosis required correction because of kinking. There were two hospital deaths: one patient died of multiple organ failure in the perioperative period and the other died of a recurrence of the disease. The remaining four patients were tolerating a regular diet at discharge from the hospital. Five of the six patients were able to achieve a fair to good voice.
Kawahara
H
H
Surgical Division, Kawasaki City Ida Hospital, Kanagawa, Japan.
Shiraishi
T
T
Yasugawa
H
H
Okamura
K
K
Shirakusa
T
T
D000368:Aged; D003106:Colon; D016629:Esophagectomy; D005260:Female; D006801:Humans; D007082:Ileum; D007825:Laryngectomy; D007831:Larynx, Artificial; D008297:Male; D008875:Middle Aged; D010611:Pharyngectomy; D011183:Postoperative Complications; D013518:Surgery, Plastic / Q000379:methods*; D014831:Voice; D014832:Voice Disorders / Q000209:etiology / Q000601:surgery*