Surgical treatment of hypopharyngeal and cervical esophageal cancer

Numerous methods have been employed for esophageal replacement after total pharyngolaryngectomy‐esophagectomy. These have included the use of skin, as well as free transplantation or transposition of various abdominal viscera. The history and technical aspects of the procedures that have been used on the author's service are reviewed and results of 32 reconstructive operations are presented. Lower mortality and morbidity rates were obtained and palliation more consistently achieved with visceral transposition procedures than when the esophagus was reconstructed with skin. The 3‐year cure rate of patients undergoing resection for cancer was 21%. Gastric transposition after extrathoracic total esophagectomy is the preferred procedure for suitable patients with post‐cricoid and cervical esophageal carcinoma. Skin flaps are preferred for high hypopharyngeal tumors and in the poorest risk patients. Reversed gastric tube esophagoplasty and esophagocoloplasty are best employed for secondary rather than primary reconstruction.