Laryngoesophagectomy: Primary Closure with Laryngotracheal Autograft

Carcinoma of the postcricoid region involving the mouth of the esophagus and the posterior surface of the larynx is best treated by surgical extirpation. Lateral pharyngotomy, as suggested by Trotter,1with preservation of the larynx is a limited operation with disappointing results and has been abandoned. Radical excision of a segment of the pharynx and the upper portion of the esophagus, together with the whole of the larynx, has more recently been performed. The alternative is the relegation of the patient to a painful and lingering death. Reconstruction of the pharynx after a pharyngoesophagolaryngectomy has heretofore required prolonged hospitalization and extensive plastic repair. The operation suggested by Wookey2provided the posterior surfac of the new esophagus but bipedicle skin flaps were almost invariably required for closure. In many instances a prolonged pharyngostomy, with all its discomforts, was required, and often recurrence of the carcinoma appeared before the final