A patient previously treated of a duodenal ulcer with Billroth II reconstruction, was diagnosed of sinus pyriform carcinoma and treated by radiotherapy and chemotherapy. The tumour was not affected by the treatment and continues growing with infiltration of the larynx, trachea and esophagus. The patient was referred to us with a tumoral mass of 8 by 6 centimetres, but without extension on regional lymphonodes or distant metastases. Surgical treatment was selected by removal of pharynx, larynx, thyroid gland, regional lymphonodes, externo-thyroideus and hioideus muscle with hioid cartilage in one-block with the thoracic and abdominal esophagus. The operation was done in three fields: Cervical, Posterior Mediastinum (Transhiatal) and Abdominal Cavity. Transverse and descending colon was selected because the stomach was not useful. Colon (Isoperistaltic) was brought to the cervix through the posterior mediastinum. End-to-end pharyngo-colostomy was performed. Distal end of the colon anastomosed to the efferent jejunum (Billroth II) and ileo-colonic anastomosis distally. The movie includes the follow-up and the barium meal through the plasty.