We reported, in 1989, a one-stage surgical technique for creating a phonatory shunt after pharyngo-laryngo-esophagectomy using a free ileocolic graft (tracheoileocecal shunt: TIC shunt). Recently, we have made a further modification which is accomplished in a two-stage operative procedure. The shunt is opened during the second-stage operation for the purpose of eliminating the need for intensive care after surgery. A total of fifteen patients underwent the TIC shunt operation.The first six consecutive patients received the original one-stage procedure and the remaining nine underwent the modified technique.There was no pulmonary complication in the latter patients. It was concluded that the TIC shunt is a successful method of surgical voice restoration, and that the two-stage technique makes postoperative care more simple and easy, so that complications seem to be reduced.
