One-stage radical resection of cervical esophagus, larynx, pharynx, and neck, with immediate reconstruction.

Abstract

A ONE-STAGE operation for the treatment of patients with extensive cancer of the pharynx, hypopharynx, postcricoid areas, and cervical esophagus has been developed in the hope of mitigating the morbidity encountered in the treatment of these patients by the multiple-stage method of excision and delayed reconstruction of the pharynx and esophagus. This one-stage operation consists of radical resection of the cancerous growth in the pharynx, esophagus, and neck and immediate reestablishment of continuity between the fenestrae in the oral pharynx and cervical esophagus by the careful anastomosis of a free thick-split skin graft to these structures. The free tubed graft is covered inferiorly with the lobes of the thyroid and superiorly by the associated prevertebral fascia and the skin flaps of the neck. Postoperative contracture is mitigated by the implantation of an inert stent and bouginage. INDICATIONS Patients for whom this type of operation is indicated are divided into those