HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Ferguson, M. K. Search for Related Content PubMed PubMed Citation Articles by Ferguson, M. K.

The Annals of Thoracic Surgery, Vol 52, 336-342, Copyright © 1991 by The Society of Thoracic Surgeons

ARTICLES

Achalasia: current evaluation and therapy

MK Ferguson
Department of Surgery, University of Chicago Hospitals, Illinois 60637.

The current evaluation of and therapy for achalasia are reviewed. Esophageal manometry remains the best means for diagnosing achalasia. Initial therapy can include either pneumatic dilation or esophagomyotomy. Symptomatic improvement occurs in 71% of patients after pneumatic dilation, with a risk of perforation of 1.4%. Eight percent of these patients require subsequent esophagomyotomy. Surgical procedures for achalasia can be performed through either an abdominal or a thoracic incision. Nearly all authors favoring an abdominal approach add an antireflux operation to esophagomyotomy, whereas many authors advocating a transthoracic esophagomyotomy believe that an antireflux wrap is unnecessary. Overall results for the various surgical approaches used as initial therapy are excellent, with symptomatic improvement in 89% of patients, a mortality rate of less than 1%, and development of gastroesophageal acid reflux in less than 10%. Factors governing the choice of initial therapy are discussed.

This article has been cited by other articles:

				H. A. Gaissert, N. Lin, J. C. Wain, G. Fankhauser, C. D. Wright, and D. J. Mathisen Transthoracic Heller Myotomy for Esophageal Achalasia: Analysis of Long-Term Results Ann. Thorac. Surg., June 1, 2006; 81(6): 2044 - 2049. [Abstract] [Full Text] [PDF]

				V. I. Onopriev, V. M. Durleshter, and V. V. Ryabchun Comparative pre- and postoperative results analysis of functional state of the esophagus assessment in patients with various stages of achalasia Eur. J. Cardiothorac. Surg., July 1, 2005; 28(1): 1 - 6. [Abstract] [Full Text] [PDF]

				M. G. Patti, A. Tamburini, and C. A. Pellegrini Cardiomyotomy Surgical Innovation, December 1, 1999; 6(4): 186 - 193. [Abstract] [PDF]

				R. J. Wiechmann, M. K. Ferguson, K. S. Naunheim, S. R. Hazelrigg, M. J. Mack, R. J. Aronoff, R. J. Weyant, T. Santucci, R. Macherey, and R. J. Landreneau VIDEO-ASSISTED SURGICAL MANAGEMENT OF ACHALASIA OF THE ESOPHAGUS J. Thorac. Cardiovasc. Surg., November 1, 1999; 118(5): 916 - 923. [Abstract] [Full Text] [PDF]

				A. J. Graham, R. J. Finley, D. F. Worsley, S. R. Dong, J. C. Clifton, and C. Storseth Laparoscopic Esophageal Myotomy and Anterior Partial Fundoplication for the Treatment of Achalasia Ann. Thorac. Surg., September 1, 1997; 64(3): 785 - 789. [Abstract] [Full Text]

				M. Anselmino, G. Perdikis, R. A. Hinder, P. V. Polishuk, P. Wilson, J. D. Terry, and S. J. Lanspa Heller Myotomy Is Superior to Dilatation for the Treatment of Early Achalasia Arch Surg, March 1, 1997; 132(3): 233 - 240. [Abstract] [PDF]

				E. Cosentini, G. Berlakovich, J. Zacherl, G. Stacher-Janotta, R. Merio, E. Wenzl, H. Bergmann, and G. Stacher Achalasia: Results of Myotomy and Antireflux Operation After Failed Dilatations Arch Surg, February 1, 1997; 132(2): 143 - 147. [Abstract] [PDF]

				M. K. Ferguson, L. B. Reeder, and J. Olak Results of Myotomy and Partial Fundoplication After Pneumatic Dilation for Achalasia Ann. Thorac. Surg., August 1, 1996; 62(2): 327 - 330. [Abstract] [Full Text]

				M. G. Patti, C. A. Pellegrini, M. Arcerito, J. Tong, S. J. Mulvihill, and L. W. Way Comparison of Medical and Minimally Invasive Surgical Therapy for Primary Esophageal Motility Disorders Arch Surg, June 1, 1995; 130(6): 609 - 616. [Abstract] [PDF]