Esophageal reconstruction using a hypopharyngeal anastomosis – a single center experience with review of the literature

Lye ingestion or other esophageal trauma may require surgical reconstruction. The hypopharyngeal anastomosis during esophageal reconstruction is a technically demanding procedure with many nuances in approach. Patients often have a challenging post-operative course, and few regain the ability to tolerate a normal diet. We describe a case series of three patients (2 colon interpositions and 1 gastric pull-up) who underwent esophageal reconstruction with a hypopharyngeal anastomosis at our institution from years 2017 to 2024, then review the literature. We recommend a multidisciplinary team approach with otolaryngology and/or general surgery for the neck dissection and preparation of the conduit. For the hypopharyngeal anastomosis, we recommend a two-layer, interrupted suture method to the left, lateral piriform sinus along with careful laryngeal nerve preservation. Patients require close follow-up for endoscopic therapy to treat the often-inevitable dysphagia after surgery. All three patients survived and had improved swallow function after surgery.