Abstract:Objective To investigate the application of gastric pull-up reconstruction after hypopharyngo-esophagectomy and analyze the clinical characteristics of carcinoma of hypopharynx and cervical esophagus.Methods Clinical data of 5 patients with gastric pull-up reconstruction after hypopharyngo-esophagectomy for carcinoma of hypopharynx and cervical esophagus were retrospectively analyzed.Results Of all the 5 cases, 4 were newly diagnosed and one was recurrent. The gastric pull-up reconstruction was assisted with thoracoscope in 4 cases and Da Vinci robot in one. Hypopharyngo-esophagectomy with reserved laryngeal function was carried out in 2 cases, and hypopharyngo-laryngo-esophagectomy was performed in 3. Postoperative pathological diagnosis revealed 4 cases of squamous cell carcinoma and one of adenocarcinoma. Postoperative transient thoracic fistula occurred in one case, pharyngeal fistula after radiotherapy in another. All patients resumed oral intake within one month after surgery. The postoperative follow-up of 6 to 44 months revealed that 3 cases died, due to pulmonary hemorrhage 6 months postoperatively in one, local recurrence with heart failure 13 months in another, and esophageal and lung metastasis 44 months in one. Two patients survived with tumor including one with lung metastasis 1 year postoperative, and the other with cervical lymph node metastasis 3 months and abdominal lymph node and adrenal metastases 11 months postoperative.Conclusions The malignant degree of hypopharyngeal and cervical esophageal cancer is high, and adenocarcinoma is rare. With controllable perioperative complication, gastric pull-up assisted with thoracoscope or Da Vinci robot is worthy of recommendation for reconstruction after hypopharyngo-esophagectomy.
