Surgical Treatment of Achalasia

¹ Associate Professor of Surgery

Seventy-three patients treated for achalasia have been reviewed. Forty-four per cent of those treated by forceful esophageal dilation had a good result, but esophageal perforation during dilation occurred in 9.4 per cent with an over-all 3 per cent mortality rate. In contrast, almost 80 per cent of the patients who had a modified Heller procedure were judged to have a good result. There was no mortality alter this operation.

Those few who had dysphagia after esophagomyotomy have been critically analyzed. The reasons for failure and additional technics to help prevent postoperative reflux esophagitis are discussed.

The indications for the surgical treatment of achalasia need to be re-evaluated. When properly performed, esophagomyotomy is safe, effective treatment for achalasia and deserves consideration as a primary method of therapy in selected patients.