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Ann Thorac Surg 1995;60:1821-1823
© 1995 The Society of Thoracic Surgeons

How to Do It

Anastomosis Technique for High Pharyngogastrostomy

Mark J. Krasna, MD, Stanley D. Phillips, MD, William C. Gray, MD, John F. Biedlingmaier, MD

Divisions of Otolaryngology and Thoracic and Cardiovascular Surgery, University of Maryland Medical School, Baltimore, Maryland

Accepted for publication July 6, 1995.

Pharyngogastric anastomosis, otherwise referred to as the ``gastric pull-up'' procedure, is the most reliable method of reconstruction after laryngopharyngectomy. We currently use a method of gastric to pharyngeal anastomosis that avoids excess tension, and thus decreases the incidence of fistulas and flap failures. With the stomach fully mobilized, the ``pull-up'' is brought high into the neck using a plastic bag to facilitate delivery via the posterior mediastinum. A curved, U-shaped incision is then made in the fundus of the tongue anteriorly, allowing the posterior nasopharynx to be reached without tension.






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