Gastric functions in patients with the intrathoracic stomach after esophageal surgery.

Functions of the stomach placed in the posterior mediastinum after esophagectomy were studied in 20 esophageal carcinoma patients. Seven were long-term survivors who lived more than 5 years after operation, and five of them showed normal fasting serum gastrin levels and good or fair gastric acid secretion. Of 13 patients who had their operations within 3 years before the study, 11 showed high fasting serum gastrin levels and poor gastric acid secretion. The hepatobiliary and alimentary scintigrams with double isotopes demonstrated a time lag between the excretion of the food from the stomach and the excretion of bile into the bowels, regardless of the postoperative periods. Absorption of vitamin B12 was normal in patients who lived more than 2 years after operation. The intraluminal pressure and pH studies in long-term survivors showed that our operative technique, the posterior invagination esophagogastrostomy, was effective in preventing a gastroesophageal reflux in the anastomosis.