Technical details of a primary reconstruction of the cervical esophagus using pectoralis major myocutaneous island flap were discussed with some clinical case reports. Versatility of this flap was stressed along with some shortcomings, being compared with DP skin flap. Conclusions are as follows;
1. Pectoralis major myocutaneous island flap is good enough to reconstruct the cervical esophagus after removing extensive cancer in the hypopharynx.
2. Patients can begin to swallow in 19th postoperative day on the average, which is much shorter than 53rd in patients with DP skin flap.
3. Delay procedure is unnecessary in every case.
4. Thoracoacromial artery runs down on the anterior chest wall so in constant position that the designing of the flap is technically easy.
5. Postoperative care is extremely simple.
6. There may be no danger of flap necrosis and resultant stenosis.
7. The flap may not be indicated for a woman with a buxom breast.
8. The flap may not be indicated for a woman with a thick subdermal adipose tissue.
