Choice Of The Substitute For The Esophagus After Hypopharyngoesophagectomy

The stomach and the colon are often used as substi-tutes of the pharyngoesophagus in head and. neck cancer surgery. Replacement of the esophagus with colon is now performed less frequently than in the past because of a higher morbidity and mortality. The stomach is the organ used most often in recent years. Reconstructive techniques after pharyngoesophagectomy are reviewed. We studied the functions of the substitutes by using isotopic tests of gastric emptying, esophageal transit test, upper gastrointestinal x-ray examination with barium and endoscopy. We set up six scales and criteria for evaluation of the function and living quality of long-term survival patients. There were 20 patients having gastric pull-ups and 15 having colon transplants who were evaluated with the criteria. The functional scales and scores in the patients of colon interposition were superior to those of the gastric transplants ( P 0.01). Clinical data proved that postoperative reflux could be reduced signigicantly...