[Total pharyngolaryngoesophagectomy and gastric pull-up: an evaluation of 10 cases]

We evaluated the patients who underwent total pharyngolaryngoesophagectomy (T-PLE) and gastric pull-up (GPU) for hypopharyngeal tumors extending to the cervical esophagus.

Ten patients (8 females, 2 males; mean age 50 years; range 39 to 60 years) were treated with T-PLE and GPU, total thyroidectomy, and bilateral neck dissection including zone VI. Histopathologic diagnoses were squamous cell carcinoma (n = 8), basaloid squamous cell carcinoma (n = 1), and adenoid cystic carcinoma (n = 1). Clinical stage, tumor stage, and nodal status were as follows: eight patients IVA, two patients III; eight patients T4a, two patients T3; seven patients N+ (6 N2, 1 N1), three patients N0.

Three patients (30%) died within a month after surgery. Two patients were alive after the seventh and first postoperative years, respectively. The remaining five patients died because of causes related (n = 3) to or unrelated (n = 2) to carcinoma. Survival was 20% for one year, and 14.3% for five years. Histopathologically, surgical margins were free of tumor in nine cases. The mean time to the initiation of oral feeding was nine days (range 4 to 14 days), and the mean hospital stay was 23 days (range 12 to 36 days).

Early initiation of oral feeding and relatively short hospitalization periods make T-PLE and GPU an appropriate palliative procedure, increasing the quality of life for many patients.