Should Modified Heller’s Cardiomyotomy Be Combined with Antireflux Procedure

Abstract

Achalasia, one of the diffuse motor disorders, is characterized by the absence of the primary peristalsis of the esophagus. The response to normal deglutition is characterized by the absence of peristalsis in the body of the esophagus and the failure of the relaxation usually found in the hypertrophic lower sphincter [1]. The etiology is unknown. Pathologically, achalasia is confirmed by the lack or degeneration of Auerbach’s plexus, and structural changes in the muscular layer of the lower esophagus [2, 3]. It leads to dilatation of the esophagus above a functional stricture with typical symptoms: dysphagia especially in emotional situations, vomiting, chest pain, weight loss, and broncho-pulmonary complications [1, 3, 4, 5].