Gastric transposition in head and neck surgery. Indications, complications, and expectations

From 1973 through 1982 a total of 63 of our patients had their upper alimentary tracts reconstructed after major ablative neck operations by transposition of the mobilized stomach into the neck through the bed of the resected esophagus. This gastric pull-up procedure was performed without thoracotomy using two surgical teams for resection of locally extensive primary tumors arising in the hypopharynx, cervical esophagus, and thyroid gland. Morbidity and mortality were significant but acceptable. Relatively few patients were cured, but excellent palliation was often achieved. In our experience, use of the transposed stomach for restoration of alimentary continuity after cervical esophagectomy or circumferential pharyngectomy offered greater reliability and versatility than other available methods.