
Hypopharyngeal Reconstruction: A Comparison of Two Alternatives
YOSEF P. KRESPI, MD
Brooklyn, NY
Arch Otolaryngol Head Neck Surg. 1989;115(7):777.
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At the recent meeting of the Eastern Section of The Triological Society in Toronto, Canada, Egbert J. de Vries and colleagues from the University of Pittsburgh (Pa) presented their experience with hypopharyngeal reconstruction after total laryngopharyngectomy. Gastric pull-up (GP) was performed in 14 patients, and free jejunal interposition (JI) in 17 patients. Stage IV disease was the predominant diagnosis in both groups. There was one perioperative mortality in the GP group. Fistula occurred in 14% of the GP group and in 24% of the JI group. Stricture occurred in 24% of the JI group and in none of the GP patients. Swallowing was achieved in 86% following GP and in 82% following JI. However, patients with JI were able to swallow sooner and were also discharged from the hospital sooner. Forty-seven percent of the JI patients are alive with no evidence of disease. Fourteen percent of the GP patients are
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