Gastric tube transposition for cancer of the hypopharynx and cervical oesophagus

Abstract

A study of 20 cases of gastric tube transposition following total laryngopharyngoesophagectomy during an eight-year period is presented. The site of the tumour was: hypopharynx in 13 cases (12 pyriform sinus, 1 post-cricoid); and cervical oesophagus in seven cases. There were nine (45 per cent) Stage III lesions and 11 (55 per cent) Stage IV lesions (UICC, 1987). Post-operative morbidity rate was 15 per cent. Hospital mortality rate was 10 per cent (cause of death was myocardial infarction). Anastomotic fistula rate was five per cent. Excluding hospital mortality, the three year actuarial survival rate was 35 per cent for the whole series and 53 percent for patients with hypopharyngeal cancer. The actuarial survival rate for patients with oesophageal cancer at one and two years was 41 and zero per cent respectively. The transposition of a tubed stomach provided successful swallowing in two-thirds of the patients for a period of more than a year and these patients developed good neoesophageal speech.