August 1971

Reoperation for Achalasia of the Esophagus

Author Affiliations

Rochester, Minn
From the Mayo Graduate School of Medicine (University of Minnesota), Rochester (Dr. Patrick); and the Division of Thoracic Diseases and Internal Medicine (Dr. Olsen) and Section of Thoracic, Cardiovascular, and General Surgery (Drs. Payne and Ellis), Mayo Clinic and Mayo Foundation, Rochester, Minn.

Arch Surg. 1971;103(2):122-128. doi:10.1001/archsurg.1971.01350080038005

Twenty-one patients underwent reoperation for achalasia after various unsuccessful surgical procedures designed to relieve chronic esophageal symptoms. The chief cause for their continued disability was either persistent obstructive achalasia or incompetence of the cardia with esophagitis and stricture. Continued esophageal obstruction with persistent achalasia was caused chiefly by complete or partial healing of a previous improperly performed esophagomyotomy. The performance of a new myotomy at reoperation usually effected a satisfactory result. Incompetence of the cardia followed previous operations which totally destroyed or bypassed the distal esophageal sphincter. At reoperation, the resultant lower esophageal stricture required resection for relief.