The Annals of Thoracic Surgery, Vol 29, 184-191, Copyright © 1980 by The Society of Thoracic Surgeons
Operation for motor dysfunction of the esophagus
GF Murray
Modern operative treatment of motor dysfunction of the esophagus began in
1949 with the recognition that anastomotic procedures that bypass or
destroy the distal esophageal sphincter are associated with the development
of reflux esophagitis and stricture. Thirty years later, reflux esophagitis
related to esophagomyotomy or intrinsic esophageal disease remains the
dominant concern and challenge. This review examines the current status of
operative procedures for the management of three important primary
disorders of esophageal motility: achalasia, diffuse esophageal spasm, and
scleroderma. Relief of esophageal obstruction by esophagomyotomy or
reconstruction is the common surgical goal. The addition of a
fundoplication procedure to discourage esophageal reflux remains
controversial in each disorder. Esophageal resection may become necessary
when stricture persists or esophagomyotomy fails to provide lasting relief
of dysphagia.
