Prevention of postoperative gastroesophageal reflux by preservation of lower esophageal sphincter in partial esophagectomy.

Postoperative reflux esophagitis is a common complication after partial removal of the esophagus and the whole gastric cardia for reconstruction through esophagogastrostomy. In 10 cases, the lower esophageal sphincter (LES) was preserved for a length of 2.05 +/- 0.33cm (mean +/- S) during partial esophagectomy for benign or malignant lesion at the middle and lower portion of the thoracic esophagus. The mean value of the LES pressures measured two weeks after operations was 2.40 +/- 0.64 kPa (18 +/- 4.8 mmHg) and the postoperative X-ray barium meal examination revealed no evidence of gastroesophageal reflux. Our study suggested that the preserved LES should effectively act as a functional barrier against the development of reflux esophagitis.