title: Reconstruction of Hypopharyngeal and Esophageal Defects Using a Gastric Tube after Total Esophagectomy and Pharyngolaryngectomy.
abstract: OBJECTIVE
  This study investigated the value of gastric tube during surgery for advanced hypopharyngeal and cervical esophageal cancer.
  
  
  METHODS
  From November 2007 to December 2012, 42 patients underwent total pharyngo-laryngo-esophagectomy because of advanced hypopharyngeal or cervical esophageal cancer and were reconstructed with a gastric tube. Clinical swallowing function, morbidity, overall survival, and progression-free survival were evaluated postoperatively.
  
  
  RESULTS
  There were no severe complications, including no gastric necrosis, surgery-related postoperative morbidity, hemothorax, thoracostomach, or severe reflux esophagitis. Anastomotic leakage occurred in 2 cases, and these patients healed spontaneously with conservative management. Pulmonary infection developed in 5 patients. Anastomotic stenosis occurred in 2 cases and was managed with endoscopic dilatation. Regurgitation during the night was observed in 5 cases and was controlled by medication. All the patients regained their swallowing ability and thereby increased their quality of life. All patients were followed for 30-60 months; 2 of them were lost 6 months after surgery. The 3-year overall and progression-free survival rates were 58.1 and 56.2% respectively, and the 5-year overall and progression-free survival rates were 27.6 and 21.8%, respectively.
  
  
  CONCLUSIONS
  Reconstruction by gastric tube is a dependable one-stage procedure that restores gastrointestinal continuity after total pharyngo-laryngo-esophagectomy.
authors.affiliation: Department of Head and Neck Surgery, Sichuan Cancer Hospital, Chengdu, PR China.
authors.forename: Jifeng
authors.initials: J
authors.lastname: Liu
authors.forename: Tiehong
authors.initials: T
authors.lastname: Deng
authors.forename: Chao
authors.initials: C
authors.lastname: Li
authors.forename: Lin
authors.initials: L
authors.lastname: Peng
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.forename: Guiquan
authors.initials: G
authors.lastname: Zhu
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.forename: Yongcong
authors.initials: Y
authors.lastname: Cai
authors.forename: Xiaojiao
authors.initials: X
authors.lastname: Lan
authors.forename: Yuxin
authors.initials: Y
authors.lastname: He
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Wang
authors.forename: Shaoxin
authors.initials: S
authors.lastname: Wang
mesh_terms: D000368:Aged; D002681:China; D015331:Cohort Studies; D018572:Disease-Free Survival; D004750:Enteral Nutrition; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D053208:Kaplan-Meier Estimate; D007828:Laryngoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010611:Pharyngectomy / Q000379:methods*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000295:instrumentation* / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome