Esophagomyotomy for noncardiac chest pain resulting from diffuse esophageal spasm and related disorders

Esophagomyotomy was performed in 42 patients with chest pain resulting from diffuse esophageal spasm and related disorders. The procedure used restricted the myotomy to the diseased portion of the esophagus, as demonstrated manometrically. More than half of the patients also required myotomy of the lower esophageal sphincter. Some patients required other surgical procedures. Overall results were excellent; the overall improvement rate was 70% at a median follow up of 5 years, 8 months. Postoperatively, 5 patients had recurrent or persistent pain. Esophagomyotomy is recommended for selected patients with clinically significant chest pain and/or dysphagia.