Operative Treatment of Achalasia

Abstract

Indications for surgical treatment:

• 1. Advanced achalasia, with dilatation of the esophagus and significant food retention.

• 2. Failed initial dilatation.

• 3. Technical difficulty in placing a forceful dilator.

• 4. Severe retention esophagitis with an increased risk of instrumental trauma.

• 5. Confirmed or threatened aspiration pneumonitis in cases where the response to dilatation is deemed unsatisfactory in terms of reducing the capacity of the organ for food retention.

• 6. Co-existence of a hiatal hernia.

• 7. Suspected cancer.

• 8. Previous attempts at myotomy.

• 9. The patient’s intolerance of repeated dilatation.