Gastric Pull up Versus Free Flap Reconstruction for Laryngo-pharyngeal Defects

Surgical Time

Time from first incision to the end of surgical closure as documented on the nursing record.

Time frame: Initial Surgery

Operative blood loss

Total volume of blood lost and accounted for in suction canisters as documented in nursing charts. (this excludes blood not accounted for in the suction containers)

Time frame: Initial surgery

Operative Parameters

Requirement for transfusion, measured in units of blood.

Time frame: During initial surgery and within the first 72 hours.

Flap Donor Site Morbidity (RFFF) )

Donor site associated quality of life (Toronto Extremity Salvage Score - Upper Extremity)

Time frame: Measure documented at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (8 visits total)

Flap Donor Site Morbidity (ALT)

Donor site associated quality of life (Toronto Extremity Salvage Score - Lower Extremity)

Time frame: Measure documented at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (8 visits total)

Time to return to swallowing

Time from surgery to swallowing liquids.

Time frame: If occurs in hospital will be documented by the treating team. Otherwise will be documented based on patient or speech language pathology reporting at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (9 visits total)

Time to return of FULL oral diet

Time from surgery to return of diet that is sufficient for patient to maintain nutrition without requiring G-tube or NG feeding. Patient or Speech Language Pathology reported.

Time frame: Measure documented at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (9 visits total)

Requirement for feeding tube at 1 year after surgery.

Whether patients are still feeding tube dependent for nutrition at 1 year follow up.

Time frame: Documented at 1 year follow up visit.

Voice Function

Measured by Voice Handicap Index -10

Time frame: Measure documented at time of surgical booking and at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (9 visits total)

Dysphagia

M.D. Anderson Dysphagia Inventory for assessment of dysphagia

Time frame: Measure documented at time of surgical booking and at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (9 visits total)

Dumping Symptoms

Assessed with the dumping symptom rating scale

Time frame: Measure documented at time of surgical booking and at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (9 visits total)

Quality of Life

Measure with combined scores of two questionnaires: European Organization for Research and Treatment of Cancer Quality of Life (EORTC QLQ) - C30 and EORTC QLQ - H\&N35

Time frame: Measure documented at 1, 3, 6 and 12 months post-surgery, thereafter yearly for 5 years. (8 visits total)

Margin status of the resected specimen as reported by pathology

Will be classified as positive and negative based on what is reported at Vancouver General Hospital Pathology reports generated at the time of surgery. A measure of clearance in millimeters will also be provided.

Time frame: At the time of surgery

Time to progression

time from the date of the surgery until local, regional, or metastatic disease is detected

Time frame: Patients will be monitored for 5 years post-operatively

Disease Free Survival

Time from the date of the surgery until a patient experiences a recurrence, a new primary cancer or death

Time frame: Patients will be monitored for 5 years post-operatively

Progression-free survival

Time from the date of the surgery until a patient shows sign of disease progression

Time frame: Patients will be monitored for 5 years post-operatively