Abstract: It was believed that if the distal end of the esophagus (lower esophageal sphincter, LES)was preserved intact,and esophageal end-to-end anastomosis combined gastric fundoplication were made,postoperative gastroesophageal reflux (GER) could be prevented.Such operation has been done in 14 cases with middle third esophageal cancer by the authors.Manometry before operation showed that the mean value of pressure of the LES was within normal range, 2.57士0.21kPa.No obvious difference compared with that of the control group (n=30, x=2.51士0.48kPa) (P> 0.05).Postoperatively,the mean value of the LES pressure was 1.66士0.40kPa, it was obviously lower than that of preoperative determination (P<0.05).Postoperative pressure of intrathorncic stomach was 1.09士0.44kPa, and that of residual esophagus was 1.02士0.36kPa.So, there was a common cavity between intrathoracic stomach and residual esophagus as the pressures of both were similiar.It was considered that preserved LES no more was a barrier for preventing GER.