Reconstructive techniques currently used following resection of hypopharyngeal carcinoma

There is no general consensus as to the best method of reconstruction follo wing total laryngopharyngectomy for hypopharyngeal carcinoma. The aim of th is study is to attempt to establish the current practice amongst British EN T Consultants and to ascertain the reasons for their choice of reconstructi ve technique. An anonymous questionnaire was sent to 546 consultants in the UK and the re sults of 363 (66.5 per cent) were analysed. One hundred and twenty-eight (3 5.3 per cent) consultants replied that they performed surgery for hypophary ngeal carcinoma. Sixty-five (50.8 per cent) performed a stomach pull up pro cedure, 23 (18 per cent) used a jejunal free flap, 36 (28.1 per cent) used both and four (3.1 per cent) used other techniques. In the stomach pull-up group, the main reasons given for their choice were because there was no lo wer resection margin (48 out of 65) and because of tradition in the way the y were trained (37 out of 65). In the group using the jejunal free flap, lo wer morbidity (18 out of 23) and mortality (14 out of 23) were the main rea sons for their choice. The questionnaire also found that amongst the 60 con sultants who would consider using a jejunal free flap, the majority (39) ai med for a lower clearance margin of 2-4 cm, while 17 aimed for >4 cm cleara nce. This study provides a good indication of the current practice in the UK of reconstruction following resection for hypopharyngeal carcinoma. It appears that the stomach pull-up remains the most commonly used method of reconstr uction, but the jejunal free flap is becoming increasingly more popular bec ause of its lower morbidity and mortality.