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Related Concept Videos

Esophageal Achalasia01:27

Esophageal Achalasia

Esophageal achalasia is a chronic neurogenic disorder characterized by impaired relaxation of the lower esophageal sphincter (LES) and absent or ineffective peristalsis in the distal esophagus. This leads to a functional obstruction without a physical blockage, despite significant disruption of esophageal motility.EtiologyAchalasia is caused by degeneration of the myenteric (Auerbach's) plexus, specifically the loss of inhibitory ganglion cells that produce vasoactive intestinal peptide (VIP)...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Barrett Esophagus-II: Clinical Manifestations and Management01:21

Barrett Esophagus-II: Clinical Manifestations and Management

Individuals with Barrett's esophagus are often asymptomatic, but they may experience symptoms commonly associated with GERD, such as heartburn and acid regurgitation. Additional symptoms can include difficulty swallowing, chest pain, unintentional weight loss, blood in the stool (which may appear black, tarry, or bloody), and episodes of vomiting.
To diagnose Barrett's esophagus, healthcare providers often recommend an endoscopy for those showing symptoms of acid reflux. The procedure entails...
Pyloric Obstruction01:11

Pyloric Obstruction

Pyloric obstruction, also referred to as gastric outlet obstruction, is a condition characterized by narrowing or blockage at the pylorus—the muscular valve regulating the flow of stomach contents into the duodenum. When this passage becomes impaired, the stomach cannot effectively empty its contents into the small intestine. This disruption leads to a range of gastrointestinal symptoms, including early satiety, bloating, epigastric pain, postprandial nausea, persistent vomiting, and...
Esophageal Strictures-I: Introduction01:30

Esophageal Strictures-I: Introduction

Esophageal strictures involve abnormal narrowing or tightening of the esophagus. They vary in length and severity, ranging from mild constriction to complete obstruction, and are classified as benign (noncancerous) or malignant (cancerous).
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Hiatal Hernia01:25

Hiatal Hernia

A hiatal hernia is the abnormal protrusion of the stomach or other abdominal organs through the esophageal hiatus of the diaphragm into the thoracic cavity.Normally, the gastroesophageal junction (GEJ) lies below the diaphragm and is supported by the phrenoesophageal membrane, the diaphragmatic crura, and connective tissues. Weakening of these structures—due to aging, congenital defects like a short esophagus, or increased intra-abdominal pressure from coughing, obesity, pregnancy, or heavy...

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Related Experiment Video

Updated: Jun 5, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
11:19

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

End-stage achalasia.

A Duranceau1, M Liberman, J Martin

  • 1Department of Surgery, Université de Montréal, Division of Thoracic Surgery, Centre Hospitalier de l'Université de Montréal, Montréal, Québec, Canada. andre.duranceau@umontreal.ca

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|December 21, 2010
PubMed
Summary
This summary is machine-generated.

Achalasia patients may need esophagectomy despite treatment. This review covers end-stage achalasia, esophagectomy timing, and reconstructive options like gastric, colon, or jejunal interposition after esophageal resection.

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Last Updated: Jun 5, 2026

Robotic Myotomy and Partial Fundoplication for Achalasia
11:19

Robotic Myotomy and Partial Fundoplication for Achalasia

Published on: August 11, 2023

Robotic Heller Myotomy for Advancements in Surgical Management of Achalasia
09:46

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Published on: February 16, 2024

Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia

Published on: March 3, 2023

Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Esophageal Diseases

Background:

  • Achalasia treatment, including pneumatic dilation and surgical myotomy, offers symptom relief but can lead to progressive esophageal dysfunction in 10-15% of patients.
  • A subset of patients (up to 5%) may ultimately require esophagectomy due to end-stage achalasia.
  • Understanding the natural progression of achalasia and the indications for esophagectomy is crucial for patient management.

Purpose of the Study:

  • To review the natural evolution of achalasia to its end stage.
  • To discuss the optimal timing for esophagectomy in patients with advanced achalasia.
  • To explore and compare reconstructive techniques following esophagectomy for achalasia.

Main Methods:

  • Literature review focusing on the natural history of achalasia.
  • Analysis of studies reporting outcomes of pneumatic dilation and surgical myotomy.
  • Examination of data on esophagectomy for achalasia and subsequent reconstructive procedures.

Main Results:

  • Despite initial treatment success, a significant minority of achalasia patients experience disease progression necessitating esophagectomy.
  • The review analyzes the advantages and disadvantages of different esophageal reconstruction methods: gastric, colon, and jejunal interposition.
  • Specific considerations for each reconstructive approach in the context of achalasia resection are detailed.

Conclusions:

  • Esophagectomy remains a necessary intervention for end-stage achalasia in a small but significant patient group.
  • The choice of reconstruction after esophagectomy for achalasia should be individualized based on patient factors and procedural outcomes.
  • Further research may refine the understanding of optimal surgical timing and reconstructive strategies for achalasia patients requiring esophagectomy.