Achalasia of the oesophagus: management by videoendoscopic surgery

  • Carlos A. Pellegrini


Achalasia of the oesophagus is a neuromuscular disorder which leads to oesophageal dilatation in the absence of a mechanical obstruction. Dilatation appears to be related to the inability of the oesophagus to generate adequate propulsive waves and sufficient relaxation in response to swallowing. The disease affects men more often than women, and its peak incidence is between 30 and 60 years. The cause is not known, but it is thought to be related to a degenerative or infectious process which causes the destruction of the ganglion cells of Auerbach’s myenteric plexus and a hypertrophy of the circular muscle of the distal oesophagus. In areas where trypanosomiasis is endemic, such as Brazil, oesophageal dilatation similar to achalasia is seen in patients affected by Chagas’ disease.


Circular Muscle Heller Myotomy Pneumatic Dilatation Laparoscopic Heller Myotomy Lower Oesophageal Sphincter 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Skinner DB. Myotomy and achalasia. Ann Thorac Surg 1984; 37: 183–4.PubMedCrossRefGoogle Scholar
  2. 2.
    Ellis FH Jr, Crozier RE, Watkins E Jr. Operation for esophageal achalasia: results of esophagomyotomy without an antireflux operation. J Thorac Cardiovasc Surg 1984; 88: 344–51.Google Scholar
  3. 3.
    Sauer L, Pellegrini CA, Way LW. The treatment of achalasia. A current perspective. Arch Surg 1989; 124: 929–32.PubMedCrossRefGoogle Scholar
  4. 4.
    Pellegrini CA, Wetter LA, Patti Metal. Thoracoscopic esophagomyotomy: initial experience with a new approach for the treatment of achalasia. Ann Surg 1992; 216: 291–9.PubMedCentralPubMedCrossRefGoogle Scholar
  5. 5.
    Shimi S, Nathanson LK, Cuschieri A. Laparoscopie cardiomyotomy for achalasia. J R Coll Surg Edinb 1991; 36: 152–4.Google Scholar
  6. 6.
    DeMeester TR, Wang CI, Wernly JA et al. Technique, indications and clinical use of 24-hour esophageal pH monitoring. J Thorac Cardiovasc Surg 1980; 79: 656–70.PubMedGoogle Scholar
  7. 7.
    Shoenut JP, Wieler JA, Micflikier AB, Teskey JM. Esophageal reflux before and after isolated myotomy for achalasia. Surgery 1990; 108: 876–9.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1994

Authors and Affiliations

  • Carlos A. Pellegrini
    • 1
  1. 1.Department of SurgeryUniversity of WashingtonSeattleUSA

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