Prevalence and risk factors of reflux after esophagectomy for esophageal cancer

Esophagectomy is a standard treatment for resectable esophageal cancer. Although postoperative mortality and morbidity rates have been reduced, and long-term survival rate has been increased during the past decades, functional outcomes after esophagectomy have not been improved significantly. Of functional derangement after esophagectomy, reflux symptoms are commonly reported findings with prevalence from 20% to 80%. It is one of the most problematic symptoms in patients after esophagectomy (1,2). Disruption of anatomical barriers preventing gastroesophageal reflux, delayed gastrointestinal motility from bilateral vagotomy, positive abdominal pressure, and negative intrathoracic pressure can induce post-esophagectomy reflux. Reflux can lead to anastomotic stenosis and reflux esophagitis in remnant esophagus; furthermore, it can result in life-threatening aspiration pneumonia (3). Therefore, the patients who underwent esophagectomy should adjust dietary habit and change daily lifestyle. Consequently, persistence of reflux symptoms may significantly reduce quality of life after esophagectomy (4,5)