Total Laryngopharyngoesophagectomy and Tracheal Resection With Free Tissue-Reinforced Gastric Pull-Up

Total laryngopharyngoesophagectomy with tracheal resection is an uncommon procedure. The resectability of a hypopharyngeal and cervical esophageal tumor typically depends on the ability to obtain clean surgical margins. The extent of the resection requires careful surgical planning and execution. Concomitant tracheal resection and manubriectomy due to tracheal invasion increases the complexity of these already challenging conditions. Although gastric pull-up procedures have been used to successfully reconstruct laryngopharyngoesophageal defects after tumor resection, a free tissue augmented reconstructive approach should be considered in more aggressive tumors with invasion of surrounding structures. Herein, we describe the use of combining gastric pull-up with anterolateral thigh free tissue transfer for optimal repair after radical tumor resection.