Pharyngoesophageal Reconstruction-Reply

—The poor results obtained by Dr Goepfert compared with our relatively good results in our small series of patients could be explained by differences in technique. Our patients received only preoperative radiotherapy (average dose, 5,000 rad) and the new pharynx was, therefore, not irradiated. We tried to make the new pharynx as wide as possible and avoid a circular suture line above and below by interdigitating, if possible, two V-shaped tongues of muscle into complementary defects in the esophagus and the oropharynx. Our patients are able to swallow well when they leave the hospital and we send them home with a large Maloney bougie to enable them to swallow before meals. We like to examine the pharynx at endoscopy six to eight weeks following surgery. Since our article was written, we have used pectoralis major muscle alone on three further occasions for pharyngeal reconstruction, two for partial and one for