Upper alimentary tract reconstruction by laryngotracheal flap and its complex flap after resection of hypopharyngeal cancers

OBJECTIVE To study the rationality,reliability and efficacy of upper alimentary tract reconstruction by laryngo-tracheal flap and its complex flap after resection of hypopharyngeal cancers.METHODS From Dec.2002 to Nov.2010.,94 patients with hypopharyngeal cancer were underwent surgical treatment.There were 92 male and 2 female.There were 69 cases with pyriform sinus cancer,11 cases with posterior hypopharyngeal wall cancer,9 cases with postcricoid cancer and 5 cases with hypopharyngocervical esophageal cancer.According to the classification of UICC 2010,there were 1 case in stage I,9 cases in stage II,27 in stage III and 53 cases in stage IV a,4 cases in stage IV b.Thirty three of 94 patients were underwent upper alimentary tract reconstruction by laryngo-tracheal flap alone and 61 patients by complex laryngo-tracheal with pectoralis major myocutaneous flap.RESULTS All of the 94 cases were underwent operation successfully without mortality.Most of the patients resumed regular diet 10-14 days after operation.Their swallowing function restored to normal by X-ray examination.The pharyngocutaneous fistulas were found in 15(16.0%)patients,and no stenosis or atresia of the upper alimentary tract were found.The median followup was 3.5 years,the 1,3 and 5 year survival rates were 94.4%,60.5% and 39.3% respectively.CONCLUSION Laryngotracheal flap and its complex flap is a simple and safe method for upper alimentary tract reconstruction after resection of hypopharyngeal cancer and can get satisfied oncological and functional results.The technique has low morbidity and suitable for most patients with advanced hypopharyngeal cancer.