为了解决晚期下咽癌广泛切除后咽和颈段食管重建问题，我们采用小血管吻合技术，用自身的游离空肠移植重建咽和颈段食管，共完成１１例，吻合血管均成功。手术一期完成，并发症少，本组仅咽瘘２例，吻合口出血１例，术后半月经口进食，吞咽功能恢复好，手术三年成活率为３６％，死亡的主要原因是颈部淋巴结转移、复发。我们认为此法手术成功率高，安全可靠，对患者损伤比胃咽吻合术小，只要通过小血管吻合技术的训练，是可以选择此术式的。 In order to solve the problem of pharyngeal and cervical esophageal reconstruction after extensive resection of advanced hypopharyngeal carcinoma, we used small vessel anastomosis technique to reconstruct pharyngeal and cervical esophagus with its own free jejunum. The first operation was completed with fewer complications. Only two pharyngeal fistulas and one anastomotic bleeding occurred in this group. After a half months of oral feeding, the swallowing function was good and the three-year survival rate was 36%. The main cause of death was neck Department of lymph node metastasis, recurrence. We believe that this method has a high success rate of surgery, safe and reliable, less damage to the stomach than the anastomosis of the stomach, as long as the training of small vessel anastomosis techniques, is to choose this technique.