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Supercharged reversed gastric tube technique: a microvascular anastomosis procedure for pharyngo-oesophageal reconstruction after total laryngopharyngo-oesophagectomy.

OBJECTIVES
This study aimed to assess the supercharged reversed gastric tube (RGT) technique as a method for pharyngo-oesophageal reconstruction after total laryngopharyngo-oesophagectomy (TLPE).


METHODS
From May 2011 to April 2012, we performed five high anastomoses for pharyngo-oesophageal reconstructions using a supercharged RGT after TLPE in patients aged from 43 to 75 years. Synchronous hypopharyngeal and oesophageal malignancies were present in 3 patients, and they had previously received systemic chemotherapy and external irradiation at curative doses. Hypopharyngeal and oesophageal injuries due to extensive caustic trauma were present in the other 2 patients. Indications for this technique, length of the hospital stay, morbidity and mortality and functional results during the follow-up were evaluated in this retrospective review.


RESULTS
All patients had a brief operation procedure with only a single-bowel of anastomosis, no perioperative complications and an early return to a good quality of life; no mortalities were observed. After a median of 7-month follow-up, all patients were able to tolerate a regular diet and did not exhibit symptoms of reflux or dumping. Conduit strictures or redundancy has not been found to date. However, 1 patient died of distant metastatic disease.


CONCLUSIONS
The supercharged RGT technique is a safe and advantageous method for reconstructing the pharyngo-oesophageal segment in an extended surgical field and contributes to improvement in the patient's quality of life.