Refinement and Modification of Free Jejunal Graft for Pharyngeal Reconstruction after Total Laryngopharengectomy for Post Cricoid Carcinoma

Hypo pharyngeal carcinoma is relatively uncommon. No single surgical technique is superior in achieving the best oncologic and functional results. Reconstruction of the digestive tract to restore postpharyngectomy continuity is challenging. Free jejunum transfer remains the most reliable option. Micro vascular techniques minimize partial flap necrosis and the subsequent salivary fistula and are superior to pedicled flaps. Improving the results of free jejunum pharyngeal substitute is thus of utmost importance to the success of treatment of patients with hypo pharyngeal carcinoma. Methods: Refinement plan: Considerations for organ preservation determine the choice of therapy in the majority of cases. Most patients present with stage III or resectable stage IV tumors. Combined surgery and chemo-irradiation is essential for these patients. A few of our patients present as early cancers (stage I, II). Surgical ablative phase: the majority of patients need formal total laryngectomy, pharyngectomy, thyroidectomy and bilateral modified block dissection