title: Pharyngoesophageal reconstruction after resection of hypopharyngeal carcinoma: a new algorithm after analysis of 142 cases.
abstract: BACKGROUND
  The aim of this study is to define an algorithm for the choice of reconstructive method for defects after laryngo-pharyngo-esophagectomy for hypopharyngeal carcinoma.
  
  
  METHODS
  One hundred and forty two cases of hypopharyngeal carcinoma were included and operated on by either partial pharyngectomy, total pharyngectomy or esophagectomy. The reconstructive method was tailored according to the resected segment.
  
  
  RESULTS
  Pectoralis flap was used in 48 cases, free jejunal flap in 28 cases, augmented colon bypass in 4 cases, gastric pull up in 32 cases and gastric tube in 30 cases. Mean hospital stay was 12 days. Mortality rate was 10.6% and morbidity rate was 31.7%. Total flap failure occurred in 3 cases of free flap and one case of pectoralis flap. There were 23 cases of early fistula. Late stricture occurred in 19 cases, being highest with myocutaneous flap (early fistula 12/50 and late stricture 13/50).
  
  
  CONCLUSIONS
  Free jejunal flap was the flap of choice for reconstruction when the safety margin is still above the clavicle. In cases with added esophagectomy, we recommend gastric tube as a method of choice for reconstruction.
authors.affiliation: Department of Surgical Oncology, Oncology Center (OCMU), Mansoura, Daqahlia, Egypt. adeldenewer@mans.edu.eg.
authors.forename: Adel
authors.initials: A
authors.lastname: Denewer
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khater
authors.forename: Mohamed T
authors.initials: MT
authors.lastname: Hafez
authors.forename: Osama
authors.initials: O
authors.lastname: Hussein
authors.forename: Sameh
authors.initials: S
authors.lastname: Roshdy
authors.forename: Fayez
authors.initials: F
authors.lastname: Shahatto
authors.forename: Waleed
authors.initials: W
authors.lastname: Elnahas
authors.forename: Sherif
authors.initials: S
authors.lastname: Kotb
authors.forename: Khaled
authors.initials: K
authors.lastname: Mowafy
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D000714:Anastomosis, Surgical; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D007583:Jejunum / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010611:Pharyngectomy; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D015996:Survival Rate