title: [Laryngo-tracheal flap to reconstruct the defect after resection of the hypopharyngeal carcinoma with cervical esophagus involvement].
abstract: OBJECTIVE
  To investigate cervical esophageal reconstruction by means of laryngo-tracheal flap after resection of hypopharyngeal carcinoma with cervical esophageal involvement.
  
  
  METHODS
  Eleven cases of hypopharyngeal carcinoma with cervical esophageal involvement. Unilateral piriform sinus and cervical esophagus were involved in 8 cases (8/11) while bilateral piriform sinus, posterior pharyngeal wall and cervical esophagus were involved in 3 cases. After resection of laryngeal, pharyngeal and esophageal tumors and bilateral neck dissection, direct anastomosis of larynx and trachea with esophagus of cervico-thoracic segment was performed if circular structure of larynx and trachea could be preserved (3/11), pectoralis major myocutaneous flap was employed if only part of pharynx and larynx could be preserved (8/11). Postoperative radiochemotherapy was adopted and follow-up lasted for 1-5 years.
  
  
  RESULTS
  All cases healed without event except for one case of pharyngeal fistula and one case of chylous fistula which also healed after about 2 weeks dressing change. All patients got normal diet without anastomotic stricture. There was no recurrence in 6 patients at the 3 years follow-up, 4 patients had metastases in the neck and 1 patient had thoracic esophageal carcinoma with hepatic metastasis arid gave up further treatment. The overall 3-year survival rate was 54.5%.
  
  
  CONCLUSIONS
  Using laryngo-tracheal flap to reconstruct cervical esophagus after resection of hypopharyngeal carcinoma with cervical esophageal involvement is a recommendable method that is simple in processing, reliable in effect and less in postoperative complications.
authors.forename: Wen
authors.initials: W
authors.lastname: Li
authors.forename: Liu
authors.initials: L
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Jiao
authors.initials: J
authors.lastname: Zhu
authors.forename: Liqing
authors.initials: L
authors.lastname: Yuan
authors.forename: Deying
authors.initials: D
authors.lastname: Gu
mesh_terms: D002294:Carcinoma, Squamous Cell; D004947:Esophagus / Q000473:pathology*; D006258:Head and Neck Neoplasms; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000601:surgery*; D007830:Larynx; D009333:Neck; D037981:Neck Dissection; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local; D010614:Pharynx; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures; D000077195:Squamous Cell Carcinoma of Head and Neck; D013524:Surgical Flaps; D015996:Survival Rate